The purpose of the ACCELERATE3 trial is to assess the efficacy of a single intra-articular (IA) injection of autologous BMAC, in one or both knees, compared to a single IA injection of Standard of Care (SOC) in patients with mild to severe knee OA.
A Pan-Canadian, Phase 3, open-label, randomized trial of bone marrow aspirate concentrate (BMAC) administration in patients with mild to severe knee OA. A total of 374 eligible patients will be randomized to BMAC or Standard of Care (SOC). Patients randomized to the interventional arm (BMAC) will have a sample of bone marrow taken (from their pelvic region) and processed at the bedside for immediate delivery back to the patient via intra-articular (IA) injection into one or both knees. All randomized patients will be followed for 48 weeks. Blood will be collected at scheduled visits for analysis. Adverse events will be monitored throughout the trial. Assessments will be performed by physical exam and standardized questionnaires related to the physical function, health, and pain of each participant will be conducted.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
374
Range of between 18.7 X 104 cells/mL and 21.8 X 106 cells/mL total nucleated cells (TNC)
Canadian Centres for Regenerative Therapy (CCRT)
Toronto, Ontario, Canada
WOMAC® Pain Subscore
To assess the efficacy of a single intra-articular (IA) injection of autologous BMAC, in one or both knees, compared to single IA injection of Standard of Care (SOC) in patients with mild to severe knee osteoarthritis (OA). The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-20 for Pain (Higher scores = worse outcome).
Time frame: Change in WOMAC® Pain Subscore (Section A, Items #1-5) as measured by VAS from Baseline to the end of Week 12.
Safety (Baseline to Day 30 post IA injection)
To assess the safety of IA injection(s) of autologous BMAC compared to SOC in patients with knee OA.
Time frame: Incidence and severity of immediate adverse events (AEs) for 30 minutes following IA injection; Incidence and severity of any AE for 30 days following IA injection; Incidence of Serious Adverse Events (SAEs)
WOMAC® Physical Function Subscore
To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-68 for Physical (Higher scores = worse outcome).
Time frame: Change in WOMAC® Physical Function Subscore (Section C, Items #8-24) as measured by VAS from Baseline to the end of Week 12.
WOMAC® Pain Subscore
To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-20 for Pain (Higher scores = worse outcome).
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Time frame: Percentage of subjects classified as 'responders' as measured by improvement in WOMAC® Pain Subscore at Week 12
WOMAC® Physical Function Subscore
To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-68 for Physical (Higher scores = worse outcome).
Time frame: Percentage of subjects classified as 'responders' as measured by improvement in WOMAC® Physical Function Subscore at Week 12
WOMAC® Physical Function and Pain Subscore
To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-20 for Pain and 0-68 for Physical (Higher scores = worse outcome).
Time frame: Percentage of subjects classified as 'responders' as measured by a composite responder analysis at Week 12.
WOMAC® Total Score
To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-96 for a Total Score (Higher scores = worse outcome).
Time frame: Change from baseline in WOMAC® Total Score (Section A, B, and C, Items #1-24) as measured by VAS at Week 12.
WOMAC® Stiffness Subscore
To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA. The Western Ontario and McMaster Universities Arthritis Index (WOMAC) questions are scored on a scale of 0-4, which correspond to: None (0), Mild (1), Moderate (2), Severe (3), and Extreme (4). Possible score range of 0-8 for Stiffness (Higher scores = worse outcome).
Time frame: Change from Baseline in WOMAC® Stiffness Subscore (Section B, Items #6-7) as measured by VAS at Week 12
SF-12
12-Item Short Form Survey (SF-12), The data calculate two summary component scores, Physical Component Summary Score (PCS) and Mental Health Component Summary Score (MCS) with eight sub-domains. Scores range from 0 to 100, where a zero score indicates the lowest level of health and 100 indicates the highest level of health, higher scores = better outcome. To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA.
Time frame: Change From Baseline in 12-Item Short-Form (SF-12) Health Survey (Quality of Life) Scores at Week 12.
Six Minute Walk Test
The 6 Minute Walk Test is a sub-maximal exercise test used to assess aerobic capacity and endurance. The distance covered over a time of 6 minutes is used as the outcome by which to compare changes in performance capacity, higher scores = better outcome To assess the change in the quality of life achieved by IA injection(s) of autologous BMAC compared to SOC in patients with knee OA.
Time frame: Change from Baseline in the Six-Minute Walk Test at Week 12