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Knee OsteoarthritisPhase 3NCT04636229

Efficacy of Amniotic Suspension Allograft in Patients With Osteoarthritis of the Knee

A Phase 3 study testing Amniotic Suspension Allograft in people with Knee Osteoarthritis, run by Organogenesis at 38 sites in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study is being conducted to evaluate the efficacy and safety of ASA compared to placebo in the management of osteoarthritis (OA) symptoms of the knee. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Knee Osteoarthritis
What is being tested?
Amniotic Suspension Allograft
Type of treatment
Injection or infusion
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
516 participants
Where
38 sitesUnited States
Study dates
14 Dec 2020to 19 Aug 2025
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Males or females 18 years of age or older
  • Diagnosis of OA of the knee by a combination of clinical and radiographic findings
  • OA of the knee with Kellgren and Lawrence radiographic classification (Grade 2-4 inclusive) confirmed by posterior-anterior, weight-bearing, fixed flexion radiography with 10° caudal beam angulation. A specially designed positioning frame will be used to standardize the positioning for image acquisition.
  • Patients who have failed to adequately respond for at least 6 months to at least 2 OA therapies that include conservative, non-pharmacological therapy and simple analgesics (e.g., acetaminophen); nonsteroidal anti-inflammatory drugs (NSAIDS); avoidance of activities that cause joint pain; exercise; weight loss; physical therapy; and removal of excess fluid from the knee
  • Overall pain score over the previous 7 days of 11 or more on the WOMAC Pain scale.
  • Body mass index (BMI) < 40 kg/m²
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  • If female, must be postmenopausal (for at least 2 years), surgically sterilized (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), sexually abstinent, or willing and able to use 2 methods of contraception from Day 1 through 12 months after treatment
  • Males who are not surgically sterile (vasectomy) for at least 6 months prior to screening must confirm their willingness to use adequate methods of contraception from Day 1 through 12 months after treatment
  • Willing to agree not to use illicit drugs during the study, and to have illicit drug testing at screening and at later time points, if illicit drug use is suspected during the study
  • Able to comply with study requirements and complete the full sequence of protocol-related procedures and evaluations, including post-hospitalization, out-patient, and follow-up visits
  • Able to understand and provide written informed consent

Who cannot join

  • Use of pain medication (including NSAIDs and cannabidiol [CBD] oil) less than 15 days before treatment (acetaminophen allowed)
  • Regular use of anticoagulants
  • Symptoms of locking, intermittent block to range of motion, or loose body sensation that could indicate meniscal displacement or an IA loose body
  • Corticosteroid injection into the index knee within 3 months prior to screening
  • Viscosupplement (e.g., hyaluronic acid [HA]) injection, platelet-rich plasma injection, bone marrow aspirate (BMA) or bone marrow aspiration concentrate (BMAC), placental-derived tissue/cells, adipose tissue, or any other autologous or allogeneic product into the index knee within 6 months prior to screening
  • Patients with known hypersensitivity reactions to ASA or any of its constituents (e.g., HA, dimethyl sulfoxide [DMSO])
Show all 17Show fewer
  • Knee surgery on the index knee within 12 months prior to screening and/or planned knee surgery during the study
  • Knee surgery on the contralateral knee within 6 months prior to screening and/or planned knee surgery during the study
  • Acute index knee trauma within 3 months prior to screening
  • Knee effusion requiring aspiration of the index or contralateral knee within 3 months prior to screening
  • Contralateral knee pain ≥ 4 on the WOMAC Pain scale on most days during the past week.
  • Current therapy with any immunosuppressive therapy, including corticosteroids (> 5 mg/day of prednisone)
  • Clinically significant findings on the screening laboratory tests or physical examination that are not specific to OA of the knee and may interfere with study conduct or interpretation of data or increase patient risk
  • Clinically significant intercurrent illness, medical condition, non-knee pain, or medical history (including neurological or mental illness, human immunodeficiency virus, fibromyalgia, complex regional pain syndrome, or any active infection, including hepatitis B or C) that could jeopardize the patient safety, limit participation, or compromise interpretation of data derived from the patient
  • Active alcohol or substance use disorder, or any other reason that would make it unlikely for the patient to comply with study procedures
  • Females who are pregnant (positive pregnancy test at screening or prior to treatment) or lactating
  • Participation in another clinical trial within the 30 days (or 5 half-lives of the investigational compound, whichever is longer) before screening

Trial locations and contacts

38 sites in 1 country.

38 sites in 1 country

United States38 sites
  • Lehigh Center for Clinical Research

    Allentown, Pennsylvania, 18104

  • University Orthopedics Center

    Altoona, Pennsylvania, 16602

  • AARDS Research, Inc.

    Aventura, Florida, 33180

  • Sinai Hospital of Baltimore

    Baltimore, Maryland, 21215

  • Central Research Associates

    Birmingham, Alabama, 35205

  • Alabama Clinical Therapeutics

    Birmingham, Alabama, 35235

  • Injury Care Research

    Boise, Idaho, 83713

  • Tufts Medical Center

    Boston, Massachusetts, 02111

  • Cedar Health Research, LLC

    Burleson, Texas, 76028

  • Chicago Clinical Research Institute Inc

    Chicago, Illinois, 60607

  • Rush University Medical Center

    Chicago, Illinois, 60612

  • Spectrum Medical, Inc

    Danville, Virginia, 24541

  • M3 Emerging Medical Research, LLC

    Durham, North Carolina, 27704

  • Tri West Research Associates

    El Cajon, California, 92020

  • Methodist Physicians Clinic/ CCT Researc

    Fremont, Nebraska, 68025

  • Arizona Arthritis & Rheumatology Research

    Glendale, Arizona, 85306

  • PCPMG Clinical Research Unit, LLC

    Greenville, South Carolina, 29501

  • Klein & Associates, MD, PA

    Hagerstown, Maryland, 21740

  • Horizon Clinical Research Center

    La Mesa, California, 91942

  • Physician Research Collaboration

    Lincoln, Nebraska, 68516

  • Actca, A Member of the Allliance Inc.

    Los Angeles, California, 90036

  • University of California at Los Angeles

    Los Angeles, California, 90095

  • AMR Mobile

    Mobile, Alabama, 36608

  • Moore Orthopedics and Sports Medicine

    Morehead City, North Carolina, 28557

  • Affinity Health

    Nashville, Tennessee, 37203

  • NYU Langone Health

    New York, New York, 10016

  • Hospital for Special Surgery

    New York, New York, 10021

  • Lenox Hill Hospital (Northwell Health)

    New York, New York, 10075

  • Coastal Carolina Research Center

    North Charleston, South Carolina, 29406

  • Affinity Health

    Oak Brook, Illinois, 60523

  • M3 Emerging Medical Research, LLC

    Raleigh, North Carolina, 27612

  • Stanford Medicine

    Redwood City, California, 94063

  • University of California at Davis

    Sacramento, California, 95186

  • Gulfcoast Research Institute

    Sarasota, Florida, 34232

  • University Orthopedic Center

    State College, Pennsylvania, 16801

  • Pinnacle Trials, Inc.

    Stockbridge, Georgia, 30281

  • Fiel Family & Sports Medicine/ CCT Research

    Tempe, Arizona, 85283

  • Arizona Arthritis & Rheumatology Research

    Tucson, Arizona, 85704

Other trials in United States

About this study

Official title: A Phase 3 Prospective, Multicenter, Double-blind, Randomized, Placebo-controlled Study to Evaluate the Efficacy of Amniotic Suspension Allograft (ASA) in Patients With Osteoarthritis of the Knee

This study is being conducted to evaluate the efficacy and safety of ASA compared to placebo in the management of osteoarthritis (OA) symptoms of the knee.

Read the detailed description

This is a prospective, multicenter, randomized, double-blind, placebo-controlled Phase 3 study of ASA in patients with OA of the knee. Initially, 474 subjects are planned for inclusion in this study using a group sequential design with two interim analyses and a final analysis. Sample size re-estimation is planned at the second interim analysis. Based on conditional power, the maximum sample size may be increased to up to 700 patients. Patients will be randomly assigned in a 1:1 ratio to receive a single intra-articular (IA) injection of 2 mL of ASA (plus 2 mL of normal saline) or 4 mL of normal saline.

Patients will be screened after informed consent is obtained. Eligible patients will be randomized to receive a single IA injection on Day 1. They will have serial assessments of knee pain, function, and symptoms scores, as well as safety assessments for up to 52 weeks after administration of the study drug.

The planned sequence and maximum duration of the study periods will be as follows:

  • Screening: 2 weeks
  • Treatment: 1 day
  • Follow-up: 52 weeks

The maximum treatment duration for each patient is 1 day.

The maximum study duration for each patient is 54 weeks.

Efficacy will be assessed via Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder rates.

Safety will be assessed via monitoring of adverse events (AEs), safety laboratory testing, vital signs, physical examination, and concomitant medication use.

An independent data monitoring committee (DMC) with a defined charter will review study data and make preliminary decisions relative to interim analyses.

The assessments that are used in this study are standard, and are generally recognized as reliable, accurate, and relevant.

No pediatric patients will be included as OA of the knee is an age-related disorder and rarely occurs in patients under the age of 18 years. The sponsor plans to submit a waiver for studies in all pediatric age subgroups.

Being tested
Amniotic Suspension Allograft, Placebo
Keywords
Osteoarthritis, Knee, Arthritis, Joint Diseases, Musculoskeletal Diseases, Rheumatic Diseases
Medical subject headings
Osteoarthritis, Knee, Osteoarthritis, Arthritis, Joint Diseases, Musculoskeletal Diseases, Rheumatic Diseases

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Amniotic Suspension AllograftBiological

    This investigational product is a cryopreserved product derived from human amnion and cells from the amniotic fluid.

  • PlaceboDrug

    Matching placebo is 0.9% normal saline: 4 mL to be injected IA.

Study groups in NCT04636229
Study groupRoleWhat they receive
ASAExperimentalParticipants receive a single IA injection of 2 mL of ASA (plus 2 mL of normal saline)
Receives: Biological: Amniotic Suspension Allograft
PlaceboPlacebo comparatorParticipants receive a single IA injection of 4 mL of normal saline
Receives: Drug: Placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The difference in change from baseline in WOMAC Pain scale at 6 months between ASA- and placebo-treated patients

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 26

Secondary outcomes (10)
  1. The difference between changes from baseline for ASA- and placebo- treated patients in WOMAC Function at 6 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 26

  2. The difference between changes from baseline for ASA- and placebo-treated patients in the OMERACT-OARSI responder rate at 6 months

    Outcome Measures in Rheumatoid Arthritis Clinical Trials - Osteoarthritis Research Society International. (OMERACT-OARSI) Responders are defined as participants with high improvement in pain or function.

    Measured: Baseline to Week 26

  3. The difference between changes from baseline for ASA- and placebo-treated patients in WOMAC Pain at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 12

  4. The difference between changes from baseline for ASA- and placebo- treated patients in non-inferiority of WOMAC Function at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 12

  5. The difference between changes from baseline for ASA- and placebo-treated patients in the OMERACT-OARSI responder rate at 3 months

    Outcome Measures in Rheumatoid Arthritis Clinical Trials - Osteoarthritis Research Society International. (OMERACT-OARSI) Responders are defined as participants with high improvement in pain or function.

    Measured: Baseline to Week 12

  6. The difference between changes from baseline for ASA- and placebo-treated patients in the WOMAC Total at 6 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 26

  7. The difference between ASA- and placebo-treated patients in the WOMAC Stiffness at 6 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 26

  8. The difference between changes from baseline for ASA- and placebo- treated patients in the WOMAC Total at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 12

  9. The difference between changes from baseline for ASA- and placebo-treated patients in the WOMAC Stiffness at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Measured: Baseline to Week 12

  10. Incidence of adverse events (AEs)

    An AE is any untoward medical occurrence in a clinical study patient administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non-investigational) product, whether or not related to that medicinal (investigational or non-investigational) product.

    This includes any occurrence that is new in onset or aggravated in severity or frequency from the baseline condition, or abnormal result of diagnostic procedures, including clinical laboratory test abnormalities.

    Measured: Baseline to Week 52

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted19 Nov 2020
  2. Study start14 Dec 2020
  3. Primary completion30 Jul 2023
  4. Study completion19 Aug 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
This is a prospective, multicenter, randomized, double-blind, placebo-controlled study of ASA in patients with OA of the knee. Patients will be randomly assigned in a 1:1 ratio to receive a single IA injection of 2 mL of ASA (plus 2 mL of normal saline) or 4 mL of normal saline.
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
516 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04636229
Sponsor's protocol ID
19 OA 001 ASA
Status last verified
Oct 2025
First submitted
5 Nov 2020
Last updated
16 Oct 2025
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing Amniotic Suspension Allograft in people with Knee Osteoarthritis, run by Organogenesis at 38 sites in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 11 inclusion and 17 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 16 Oct 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 38 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The difference in change from baseline in WOMAC Pain scale at 6 months between ASA- and placebo-treated patients (time frame: Baseline to Week 26). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Oct 2025.

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