Phase 3
N=3,021
Long Term Safety and Efficacy Study of Tanezumab in Subjects With Osteoarthritis of the Hip or Knee
Chronic Pain · Osteoarthritis, Hip · Osteoarthritis, Knee
Bottom Line
View on ClinicalTrials.gov: NCT02528188 ↗Enrolled (actual)
3,021
Serious AEs
5.9%
Results posted
Jan 2020
Primary outcome: Primary: Percentage of Participants With Adjudicated Primary Composite Joint Safety Outcome — 3.9; 7.1; 1.5 percentage of participants — p=0.0123
Study Design & Population
- Study type
- Interventional
- Phase
- Phase 3
- Interventions
- NSAID (Drug); Tanezumab 2.5 mg (Biological); Tanezumab 5 mg (Biological)
- Age
- Adult, Older Adult · 18+ yrs
- Sex
- All
- Sponsor
- Pfizer
- Primary completion
- Oct 2018
Outcome Measures
| Outcome | Result | p-value |
|---|---|---|
| PRIMARY Percentage of Participants With Adjudicated Primary Composite Joint Safety Outcome |
3.9; 7.1; 1.5 | 0.0123 sig |
| PRIMARY Observation Time-Adjusted Event Rate of Participants With Adjudicated Primary Composite Joint Safety Outcome |
38.3; 71.5; 14.8 | 0.0012 sig |
| PRIMARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale at Week 16 |
-3.22; -3.33; -3.07 | 0.0148 sig |
| PRIMARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function Subscale at Week 16 |
-3.27; -3.39; -3.08 | 0.0030 sig |
| PRIMARY Change From Baseline in Patient's Global Assessment (PGA) of Osteoarthritis at Week 16 |
-0.96; -0.97; -0.94 | 0.3431 |
| SECONDARY Percentage of Participants With Adjudicated Secondary Composite Joint Safety Outcome |
1.0; 2.2; 0.5 | 0.4082 |
| SECONDARY Observation Time-Adjusted Event Rate of Participants With Adjudicated Secondary Composite Joint Safety Outcome |
9.7; 21.8; 4.9 | 0.2035 |
| SECONDARY Percentage of Participants With Individual Adjudicated Joint Safety Outcome |
3.2; 6.3; 1.2; 2.9; 4.9; 1.1 | 0.0248 sig |
| SECONDARY Observation Time-Adjusted Event Rate of Participants With Individual Adjudicated Joint Safety Outcome |
31.4; 63.3; 11.9; 28.4; 49.1; 10.9 | 0.0027 sig |
| SECONDARY Percentage of Participants With Total Joint Replacement or Adjudicated Primary Composite Joint Safety Outcome |
8.6; 13.1; 3.7 | 0.0002 sig |
| SECONDARY Observation Time-Adjusted Event Rate of Participants With Total Joint Replacement or Adjudicated Primary Composite Joint Safety Outcome |
84.9; 132.5; 36.7 | <0.0001 sig |
| SECONDARY Change From Baseline in Medial or Lateral Joint Space Width of the Index Knee (Kellgren-Lawrence Grade 2 or 3) at Weeks 56 and 80 |
-0.25; -0.34; -0.19; -0.33; -0.37; -0.25 | 0.0979 |
| SECONDARY Change From Baseline in Joint Space Width of the Index Hip (Kellgren-Lawrence Grade 2 or 3) at Weeks 56 and 80 |
-0.35; -0.40; -0.21; -0.46; -0.35; -0.28 | 0.1020 |
| SECONDARY Number of Participants With Progression of Osteoarthritis in the Index Knee (Kellgren-Lawrence Grade 2 or 3) According to Bland and Altman Method at Weeks 56 and 80 |
33; 43; 20; 29; 38; 16 | 0.0358 sig |
| SECONDARY Number of Participants With Progression of Osteoarthritis in the Index Hip (Kellgren-Lawrence Grade 2 or 3) According to Bland and Altman Method at Weeks 56 and 80 |
10; 10; 3; 9; 9; 3 | 0.0714 |
| SECONDARY Change From Baseline in WOMAC Pain Subscale at Weeks 2, 4, 8, 24, 32, 40, 48 and 56 |
-1.65; -1.49; -1.55; -2.25; -2.29; -1.98 | 0.2212 |
| SECONDARY Change From Baseline in WOMAC Pain Subscale at Week 64 |
7.01; 7.02; 6.96; -3.47; -3.12; -3.85 | — |
| SECONDARY Change From Baseline in WOMAC Physical Function Subscale at Weeks 2, 4, 8, 24, 32, 40, 48 and 56 |
-1.76; -1.64; -1.55; -2.29; -2.31; -1.96 | 0.0150 sig |
| SECONDARY Change From Baseline in WOMAC Physical Function Subscale at Week 64 |
7.09; 7.08; 6.99; -3.42; -3.12; -3.81 | — |
| SECONDARY Change From Baseline in Patient's Global Assessment (PGA) of Osteoarthritis at Weeks 2, 4, 8, 24, 32, 40, 48 and 56 |
-0.67; -0.67; -0.63; -0.81; -0.84; -0.69 | 0.2159 |
| SECONDARY Change From Baseline in Patient's Global Assessment (PGA) of Osteoarthritis at Week 64 |
3.49; 3.46; 3.44; -0.79; -0.64; -0.95 | — |
| SECONDARY Percentage of Participants Meeting Outcome Measures in Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) Responder Index at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56 and 64 |
46.7; 43.7; 44.8; 62.6; 62.7; 56.4 | 0.4691 |
| SECONDARY Percentage of Participants Achieving Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Reduction >=30 Percent (%), >=50%, >=70% and >=90% Response at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56 and 64 |
34.8; 30.5; 32.4; 17.8; 16.5; 14.7 | 0.2938 |
| SECONDARY Percentage of Participants With Cumulative Percent Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale at Weeks 16, 24 and 56 |
89.5; 87.6; 87.1; 85.0; 82.8; 82.8 | — |
| SECONDARY Percentage of Participants Achieving Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function Subscale Reduction of >=30%, >=50%, >=70% and >=90% Response at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56 and 64 |
35.8; 32.1; 31.7; 20.0; 17.0; 15.4 | 0.0651 |
| SECONDARY Percentage of Participants With Cumulative Percent Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function Subscale at Weeks 16, 24 and 56 |
90.0; 88.8; 87.4; 85.0; 83.9; 81.4 | — |
| SECONDARY Percentage of Participants Achieving Improvement of >=2 Points in Patient's Global Assessment (PGA) of Osteoarthritis at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56 and 64 |
14.6; 15.6; 11.6; 21.4; 22.4; 15.9 | 0.1772 |
| SECONDARY Change From Baseline in Average Pain Score in the Index Joint at Weeks 1, 2, 3, 4, 6, 8, 10, 12, 16, 20, 24, 32, 40, 48 and 56 |
-0.47; -0.56; -0.56; -1.02; -0.97; -0.91 | 0.1120 |
| SECONDARY Change From Baseline in Average Pain Score in the Index Joint at Week 64 |
6.76; 6.77; 6.76; -3.01; -2.81; -3.24 | — |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Stiffness Subscale at Weeks 2, 4, 8, 16, 24, 32, 40, 48 and 56 |
-1.79; -1.70; -1.48; -2.32; -2.43; -1.95 | 0.0004 sig |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Stiffness Subscale at Week 64 |
7.15; 7.20; 7.09; -3.31; -3.04; -3.66 | — |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Average Score at Weeks 2, 4, 8, 16, 24, 32, 40, 48 and 56 |
-1.73; -1.61; -1.52; -2.28; -2.34; -1.95 | 0.0119 sig |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Average Score at Week 64 |
7.09; 7.10; 7.01; -3.40; -3.09; -3.77 | — |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Item: Pain When Walking on a Flat Surface at Weeks 2, 4, 8, 16, 24, 32, 40, 48 and 56 |
-1.54; -1.39; -1.46; -2.14; -2.15; -1.91 | 0.3622 |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Item: Pain When Walking on a Flat Surface at Week 64 |
6.86; 6.90; 6.86; -3.20; -2.69; -3.67 | — |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Item: Pain When Going Up or Down Stairs at Weeks 2, 4, 8, 16, 24, 32, 40, 48 and 56 |
-1.81; -1.66; -1.66; -2.34; -2.43; -2.08 | 0.0846 |
| SECONDARY Change From Baseline in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Item: Pain When Going Up or Down Stairs at Week 64 |
7.89; 7.88; 7.83; -3.28; -2.97; -3.70 | — |
| SECONDARY Change From Baseline in Work Productivity and Activity Impairment Questionnaire for Osteoarthritis (WPAI:OA) Scores at Weeks 16, 24 and 56 |
-2.33; -3.35; -2.92; -28.07; -26.94; -26.59 | 0.4303 |
| SECONDARY Change From Baseline in Work Productivity and Activity Impairment Questionnaire for Osteoarthritis (WPAI:OA) Scores at Week 64 |
6.1; 6.0; 5.2; 60.5; 58.3; 59.3 | — |
| SECONDARY Number of Participants With Responses to European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L): Mobility Domain |
26; 20; 23; 203; 192; 194 | — |
| SECONDARY Number of Participants With Responses to European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L): Self-Care Domain |
251; 242; 270; 315; 295; 319 | — |
| SECONDARY Number of Participants With Responses to European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L): Usual Activities Domain |
22; 24; 38; 229; 218; 225 | — |
| SECONDARY Number of Participants With Responses to European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L): Pain/Discomfort Domain |
6; 4; 5; 81; 75; 86 | — |
| SECONDARY Number of Participants With Responses to European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L): Anxiety/ Depression Domain |
560; 570; 585; 252; 235; 236 | — |
| SECONDARY European Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L) Overall Health Utility Score/Index Value |
0.61; 0.61; 0.62; 0.74; 0.75; 0.74 | — |
| SECONDARY Treatment Satisfaction Questionnaire Medicine Version II (TSQM v.II) Score With Effectiveness, Side Effects, Convenience, and Overall Satisfaction Responses |
64.26; 66.27; 61.61; 68.61; 73.32; 71.03 | 0.0142 sig |
| SECONDARY Patient-Reported Treatment Impact Assessment- Modified (mPRTI) Score at Weeks 16 and 56: Participant Global Preference Assessment- What is The Current or Most Recent Treatment You Were Receiving for Osteoarthritis Pain Before Enrolling? |
99; 98; 82; 611; 633; 647 | — |
| SECONDARY Patient Reported Treatment Impact Assessment-Modified (mPRTI) Score at Weeks 16 and 56: Participant Global Preference Assessment- Overall, do You Prefer the Drug That You Received in This Study to Previous Treatment? |
577; 597; 531; 141; 169; 158 | 0.0823 |
| SECONDARY Patient Reported Treatment Impact Assessment-Modified (mPRTI) Score at Weeks 16 and 56: Participant Willingness to Use Drug Again Assessment- Willing to Use the Same Drug That You Have Received in This Study for Your Osteoarthritis Pain? |
627; 641; 560; 138; 154; 169 | 0.0229 sig |
| SECONDARY Number of Participants Who Withdrew Due to Lack of Efficacy |
60; 63; 91 | 0.0076 sig |
| SECONDARY Time to Discontinuation Due to Lack of Efficacy |
NA; NA; NA | 0.0074 sig |
| SECONDARY Number of Participants Who Took Rescue Medication During Weeks 2, 4, 8, 16, 24, 32, 40, 48 and 56 |
567; 548; 527; 481; 437; 469 | 0.1136 |
| SECONDARY Number of Participants Who Took Rescue Medication During Week 64 |
251; 268; 215 | — |
| SECONDARY Number of Days of Rescue Medication Used During Weeks 2, 4, 8, 16, 24, 32, 40, 48 and 56 |
2.31; 2.29; 2.26; 1.80; 1.70; 1.86 | 0.7746 |
| SECONDARY Number of Days of Rescue Medication Used During Week 64 |
2.0; 2.3; 1.7 | — |
| SECONDARY Amount of Rescue Medication Used During Weeks 2, 4, 8 and 16 |
2880.3; 2898.7; 3310.5; 2107.8; 1946.5; 2814.1 | 0.3348 |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Visits of Services Directly Related to Osteoarthritis |
1.0; 1.0; 1.0; 1.0; 1.0; 1.0 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Who Visited the Emergency Room Due to Osteoarthritis |
15; 23; 11; 10; 15; 5 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Visits to the Emergency Room Due to Osteoarthritis |
1.0; 1.0; 1.0; 1.0; 1.0; 1.0 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Hospitalized Due to Osteoarthritis |
11; 6; 1; 5; 11; 6 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Nights Stayed in the Hospital Due to Osteoarthritis |
12.0; 9.0; 11.0; 2.0; 2.0; 2.0 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Who Used Any Aids/Devices for Doing Things Due to Osteoarthritis |
852; 838; 851; 27; 18; 24 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Number of Participants Who Quit Job Due to Osteoarthritis |
47; 55; 65; 28; 35; 26 | — |
| SECONDARY Health Care Resource Utilization (HCRU): Duration Since Quitting Job Due to Osteoarthritis |
2.0; 1.8; 2.4; 2.4; 1.8; 4.0 | — |
| SECONDARY Number of Participants With Categorical Change From Baseline in Lower Extremity Activity Scale (LEAS) at Weeks 4, 8, 16, 24, 56 and 80 |
423; 421; 411; 370; 394; 369 | 0.6037 |
| SECONDARY Change From Baseline in Average Daily Minutes of Physical Activity at Weeks 16 and 56 |
97.0; 107.1; 99.2; 3.9; 2.9; -4.2 | — |
| SECONDARY Change From Baseline in Average Daily Physical Activity Counts at Weeks 16 and 56 |
75244; 95911; 74414; -470.0; -2261; 1202.9 | — |
| SECONDARY Change From Baseline in Average Daily Minutes of Moderate to Vigorous Physical Activity at Weeks 16 and 56 |
41.2; 53.1; 41.9; 0.7; -1.6; -0.1 | — |
| SECONDARY Change From Baseline in Average Daily Minutes of Bouted (Sustained) Moderate to Vigorous Physical Activity at Weeks 16 and 56 |
0.0; 0.0; 0.0; 0.0; 0.0; 0.0 | — |
| SECONDARY Change From Baseline in Average Daily Step Count at Weeks 16 and 56 |
4851.0; 5834.8; 4779.0; 350.9; 87.8; -705.7 | — |
| SECONDARY Number of Participants With Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) |
681; 744; 666; 78; 110; 66 | — |
| SECONDARY Number of Participants With Treatment-Related Treatment-Emergent Adverse Events (AEs) and Serious Adverse Events (SAEs) |
190; 250; 179; 7; 20; 7 | — |
| SECONDARY Number of Participants With Laboratory Test Abnormalities With Regard to Normal Baseline |
109; 102; 121 | — |
| SECONDARY Number of Participants With Laboratory Test Abnormalities With Regard to Abnormal Baseline |
78; 61; 84 | — |
| SECONDARY Change From Baseline in Blood Pressure (BP) at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56, 64 and 80 |
128.9; 129.3; 128.8; -2.7; -4.2; -1.2 | — |
| SECONDARY Change From Baseline in Heart Rate at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56, 64 and 80 |
70.8; 70.5; 70.6; 1.8; 2.0; 1.1 | — |
| SECONDARY Change From Baseline in Electrocardiogram (ECG) Parameters at Weeks 56 and 80 |
940.5; 940.1; 936.1; -26.3; -22.6; -14.9 | — |
| SECONDARY Change From Baseline in Heart Rate (as Assessed by ECG) at Weeks 56 and 80 |
65.2; 65.4; 65.6; 2.0; 1.7; 1.0 | — |
| SECONDARY Number of Participants With Confirmed Orthostatic Hypotension |
0; 3; 1; 2; 4; 2 | — |
| SECONDARY Change From Baseline in Survey of Autonomic Symptom (SAS) Scores at Weeks 24, 56 and 80 |
0.47; 0.53; 0.49; 0.21; 0.18; 0.11 | — |
| SECONDARY Change From Baseline in Neuropathy Impairment Score (NIS) at Weeks 2, 4, 8, 16, 24, 32, 40, 48, 56, 64 and 80 |
1.85; 1.70; 1.87; -0.22; -0.13; -0.15 | — |
| SECONDARY Number of Participants With Anti-Tanezumab Antibodies |
116; 83; 120; 93; 98; 83 | — |
Summary
The purpose of this study is to compare the long-term joint safety and efficacy (pain relief) of the investigational study drug, tanezumab compared to non-steroidal anti inflammatory drugs (NSAIDs) in subjects with osteoarthritis of the hips or knees.
Eligibility Criteria
Inclusion Criteria
- A diagnosis of osteoarthritis of the index hip or knee based on American College of Rheumatology criteria with Kellgren Lawrence X ray Grade of 2 as diagnosed by the Central Reader
- Currently receiving a stable dose regimen of oral NSAID (naproxen, celecoxib, diclofenac, aceclofenac, loxoprofen, ibuprofen, meloxicam, nabumetone, sulindac or ketoprofen) as described in the protocol along with a history of insufficient pain relief from, inability to tolerate or contraindication to taking acetaminophen and, tramadol or opioid treatments. Subjects must also maintain a stabilized, protocol specified NSAID dose regimen for at least the final 2 or 3 weeks of the Screening period
- WOMAC Pain subscale score of at least 5 in the index knee or hip at Screening
- Be willing to discontinue all non study pain medications for osteoarthritis and not use prohibited pain medications throughout the duration of the study
- Female subjects of childbearing potential must agree to comply with protocol specified contraceptive requirements
Exclusion Criteria
- Subjects exceeding protocol defined BMI or body weight limits
- History of other diseases specified in the protocol (eg, inflammatory joint diseases, crystalline diseases such as gout or pseudogout) that may involve the index joint and that could interfere with efficacy assessments
- Radiographic evidence of protocol specified bone or joint conditions in any screening radiograph as determined by the central radiology reviewer
- A history of osteonecrosis or osteoporotic fracture
- History of significant trauma or surgery to a knee, hip or shoulder within the previous year
- Planned surgical procedure during the duration of the study
- Presence of conditions (eg, fibromyaliga, radiculopathy) associated with moderate to severe pain that may confound assessments or self evaluation of osteoarthritis pain
- Signs or symptoms of carpal tunnel syndrome in the year prior to Screening
- Considered unfit for surgery based upon American Society of Anesthesiologists physical classification system for surgery grading, or subjects who would not be willing to undergo joint replacement surgery if required
- Contraindications to magnetic resonance imaging
- History of intolerance or hypersensitivity to the oral NSAID (naproxen, celecoxib or diclofenac) the subject could be randomized to receive or any of its excipients or existence of a medical condition or use of concomitant medication for which the use of this NSAID is contraindicated
- History of intolerance or hypersensitivity to acetaminophen or any of its excipients or existence of a medical condition or use of concomitant medication for which the use of acetaminophen is contraindicated
- Use of prohibited medications without the appropriate washout period prior to Screening or Initial Pain Assessment Period
- History of cancer within 5 years of Screening, except for cutaneous basal cell or squamous cell cancer resolved by excision
- Subjects with signs and symptoms of clinically significant cardiac disease as described in the protocol
- Diagnosis of a transient ischemic attack in the 6 months prior to Screening, diagnosis of stroke with residual deficits that would preclude completion of required study activities
- History, diagnosis, or signs and symptoms of clinically significant neurological disease such as but not limited to peripheral or autonomic neuropathy
- History, diagnosis, signs or symptoms of any clinically significant psychiatric disorder
- History of known alcohol, analgesic or drug abuse within 2 years of Screening
- Previous exposure to exogenous NGF or to an anti-NGF antibody
- History of allergic or anaphylactic reaction to a therapeutic or diagnostic monoclonal antibody or IgG fusion protein
- Poorly controlled hypertension as defined in the protocol or taking an antihypertensive that has not been stable for at least 1 month prior to Screening
- Evidence of protocol defined orthostatic hypotension at Screeni
Data sourced from ClinicalTrials.gov (NCT02528188). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.