Clinical trial • Phase III • Musculoskeletal

CHONDROITIN SULFATE SODIUM for Knee osteoarthritis

Phase III trial of CHONDROITIN SULFATE SODIUM for Knee osteoarthritis.

Overview

Trial Therapeutic Area
Musculoskeletal
Trial Disease
Knee osteoarthritis
Trial Stage
Phase III
Drug Modality
Other

Key dates

Initial CTIS Submission Date
06-12-2024
First CTIS Authorization Date
09-04-2025

Trial design

Randomised, bovine chondroitin sulfate 800 mg tablets (test) versus marine chondroitin sulfate 800 mg tablets (comparator); oral tablets taken for 24 weeks (6 months).-controlled Phase III trial in Czechia, Hungary, Poland.

Randomised
Yes
Comparator
Bovine chondroitin sulfate 800 mg tablets (test) versus Marine chondroitin sulfate 800 mg tablets (comparator); oral tablets taken for 24 weeks (6 months).
Target Sample Size
520
Trial Duration For Participant
252

Eligibility

Recruits 520 No vulnerable populations selected. Participants are adults (outpatients aged ≥ 50 years). Participation requires voluntarily given written informed consent encompassing consent to personal data processing; no assent process is specified..

Pregnancy Exclusion
If female of child-bearing potential, patient is non-lactating and non- pregnant, and must have a negative urine pregnancy test at the screening visit and use a reliable form of contraception throughout the study. Note: to be considered females of non-child-bearing potential, females must be postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy or hysterectomy]) or practicing one of the following medically acceptable methods of birth control: - Hormonal methods such as oral, implantable, injectable or transdermal contraceptives before IMP administration. - Agrees to abstain from heterosexual intercourse during study participation and to use a highly effective contraceptive (as described above) if they become sexually active during the study. Abstinence is only acceptable if this is the patient’s usual lifestyle. Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception. - Intrauterine device. - Double-barrier method (condoms, sponge, diaphragm, with spermicidal jellies, or cream).
Vulnerable Population
No vulnerable populations selected. Participants are adults (outpatients aged ≥ 50 years). Participation requires voluntarily given written informed consent encompassing consent to personal data processing; no assent process is specified.

Inclusion criteria

  • {"criterion_text":"- Voluntarily given informed consent to study participation in writing encompassing consent to personal data processing;"}
  • {"criterion_text":"- Outpatient of either sex, aged ≥ 50 years;"}
  • {"criterion_text":"- Patients affected by knee OA, as defined by American College of Rheumatology (ACR) clinical and radiographic criteria;"}
  • {"criterion_text":"- History of knee OA in one or both knees for > 6 months (including regular pain and functional impairment) as confirmed by the Investigator, based on available written documentation and/or patient reporting;"}
  • {"criterion_text":"- Radiographic findings of knee OA classified by Kellgren-Lawrence (K-L) grade of 2 or 3 based on an antero-posterior weight-bearing X-ray view of the target knee taken within 6 months prior to inclusion in the study. In the case that a patient has not a valid X-ray within 6 months prior to screening, the exam has to be performed during the screening period (in case that both knees have an equal intensity of pain, the target knee will be selected subjectively by the Investigator on the basis of the X-ray that will be requested for both knees);"}
  • {"criterion_text":"- Pain in the target knee verifying the following conditions: A mean score of ≥ 5 to ≤ 9 on the 24-hour average daily pain score in the target knee (on a 0-10 numeric rating scale [NRS]), where the mean is calculated over all values that are available in the 7 days prior to randomization (Day 1), and it is required that at least 5 pain score values will be available during that period; - An individual 24-hour average daily pain score in the target knee ≥ 1and ≤ 9 for all values that are available in the 7 days prior to randomization (Day 1);"}
  • {"criterion_text":"- Functional impairment in the target knee, with a mean score ≥ 3 to ≤ 9 (on a 0-10 NRS) in the Western Ontario andMcMaster Universities Arthritis Index (WOMAC®) function subscale at the baseline visit. To be eligible for the study, it is also required that patients will be able to respond at least 14 items of the WOMAC® physical function subscale, with a maximum of 3 unanswered items"}
  • {"criterion_text":"- Patient is able to understand and follow the study requirements and is familiar with the use of electronic devices;"}
  • {"criterion_text":"- If female of child-bearing potential, patient is non-lactating and non- pregnant, and must have a negative urine pregnancy test at the screening visit and use a reliable form of contraception throughout the study. Note: to be considered females of non-child-bearing potential, females must be postmenopausal for at least 1 year or surgically sterile [bilateral tubal ligation, bilateral oophorectomy or hysterectomy]) or practicing one of the following medically acceptable methods of birth control: - Hormonal methods such as oral, implantable, injectable or transdermal contraceptives before IMP administration. - Agrees to abstain from heterosexual intercourse during study participation and to use a highly effective contraceptive (as described above) if they become sexually active during the study. Abstinence is only acceptable if this is the patient’s usual lifestyle. Periodic abstinence (calendar, symptothermal, post-ovulation methods), withdrawal (coitus interruptus), spermicides only, and lactational amenorrhea method are not acceptable methods of contraception. - Intrauterine device. - Double-barrier method (condoms, sponge, diaphragm, with spermicidal jellies, or cream)."}

Exclusion criteria

  • {"criterion_text":"- Patients with predominantly patella-femoral OA defined as moderate to severe femoro-patellar OA with only no or mild femoro-tibial OA;"}
  • {"criterion_text":"- Patients with systemic inflammatory arthropathies (rheumatic disease, inflammatory or infective joint diseases or systemic lupus; recurrent clinical chondrocalcinosis; crystal arthropathies), metabolic joint diseases, osteo-articular pathologies differing from arthrosis, ochronosis, acromegaly, collagen gene mutations, or metabolic arthropathies or Paget’s illness;"}
  • {"criterion_text":"- Patients with widespread chronic musculoskeletal pain syndrome (e.g., fibromyalgia);"}
  • {"criterion_text":"- Patients with an allergy or hypersensitivity to the active substance or to any other ingredient of the IMP (i.e., CS tablets) or has a strict vegan (i.e., does not consume fish-based or meat-based products) lifestyle;"}
  • {"criterion_text":"- Patients with any clinically severe or significant uncontrolled concurrent disease that could interfere with the outcome of the study or the patient’s ability to comply with study requirements;"}
  • {"criterion_text":"- Patients with any other concurrent diseases requiring chronic use of analgesics/non-steroidal anti-inflammatory drugs (NSAIDs);"}
  • {"criterion_text":"- Patients having received: - Corticosteroids by systemic administration (oral or parenteral) in the past 30 days prior to the inclusion or corticosteroid by intra- articular administration in the past 3 months prior to the inclusion. Patients on treatment with inhaled corticosteroids can be included in the study; - Systemic short-acting (with a half-life ≤ 6 hours) (e.g., ibuprofen, ketoprofen) or long-acting NSAIDs (e.g., piroxicam, naproxen). The wash-out period begins ≥ 5 half-lives of the drug prior to Day -7 and needs to be completed prior to Day -7. For patients taking these drugs at the screening visit, patients may continue taking these drugs, provided that the indicated wash-out period is respected from 7 days prior to randomization (Day 1); - Hypnotics, muscle relaxants and anxiolytics: if intake has started < 8 days before screening and wash-out not completed prior to Day - 7; - Paracetamol or other analgesics (washout period begins ≥ 5 half- lives of the drug prior to Day -7 and needs to be completed prior to Day -7). Note: patients will be informed that, if strictly necessary, they can take rescue medication (paracetamol) in the period before Day 1 (Visit 2, baseline visit) with the exception of the 24 hr before Day 1 (Visit 2, baseline visit); - Basic treatment of arthritis with food supplements for joint care (CS, glucosamine sulphate, diacereine, hyaluronic acid, etc.) within 6 months prior to the inclusion; - Viscosupplementation, tidal lavage, platelet-rich plasma, or stem cell injection within 6 months prior to the inclusion; - Planned treatments with physical or other alternative therapies (i.e. laser therapy, ultrasound therapy, antalgic electrotherapy, tecar therapy, physiotherapy, mesotherapy, acupuncture) for the duration of the study period;"}
  • {"criterion_text":"- Patients with presence of clinically relevant psychiatric illness hindering the protocol compliance;"}
  • {"criterion_text":"- Patients with known and documented renal and/or hepatic and/or heart failure;"}
  • {"criterion_text":"- Concomitant participation in other clinical trials or participation in the evaluation of any investigational product during 3 months before this study or previous participation in the same study; months before this study or previous participation in the same study;"}
  • {"criterion_text":"- Participation in the study is also not permitted to employees of the Investigator or study site with direct involvement in the trial or in other trials under the direction of that Investigator, as well as family members of the employees or of the Investigator;"}
  • {"criterion_text":"- Patients with severe ipsilateral hip OA that could possibly confound the patient’s assessment of target knee pain in the judgement of the Investigator;"}
  • {"criterion_text":"- At the Baseline visit, patients not compliant with e-Diary use (i.e., has < 5 entries in the e-Diary during the last 7 days before the Day 1/Baseline)."}
  • {"criterion_text":"- Patients having had surgery of the target knee in the past 6 months (for arthroscopic surgery) or 12 months (for osteotomy or other surgery) prior to screening, had knee lavage in the target knee in the 6 months prior to screening, and/or significant injuries to the target knee in the 6 months prior to screening, or had knee replacement surgery on the target knee ever or has planned knee surgery on the target knee during the study;"}
  • {"criterion_text":"- Patients with body mass index (BMI) ≥ 34 kg/m2;"}
  • {"criterion_text":"- Patients with large intra-articular effusion of the target knee requiring arthrocentesis or active infection of the target knee;"}
  • {"criterion_text":"- Patients with significant pain outside the target knee, including significant back pain;"}
  • {"criterion_text":"- Patients with excessive malalignment (i.e. genu varum or valgum) that would justify an osteotomy;"}
  • {"criterion_text":"- Patients with clinically significant ligamentous laxity, or meniscal instability as assessed by the Investigator;"}
  • {"criterion_text":"- Patients with any musculoskeletal condition affecting the target knee that would impair assessment of the effectiveness in the knee;"}

Endpoints

Primary endpoints

  • {"endpoint_text":"- Change from Baseline to Week 24 in the weekly mean (7-day average) of the average daily pain in the target knee as measured by the NRS (0-10 points);","definition_or_measurement_approach":"Weekly mean (7-day average) of average daily (24-hour) pain in the target knee measured by the 0-10 Numeric Rating Scale (NRS); change from Baseline to Week 24."}
  • {"endpoint_text":"- Change from Baseline to Week 24 in mean score of WOMAC® function subscale, as measured by the NRS (0-10 points).","definition_or_measurement_approach":"Mean score on the WOMAC® function subscale measured using 0-10 NRS items; change from Baseline to Week 24."}

Secondary endpoints

  • {"endpoint_text":"- Change from Baseline to each week until Week 24 in the weekly mean of the average daily pain in the target knee as measured with the NRS;","definition_or_measurement_approach":"Weekly mean (7-day average) of average daily (24-hour) pain in the target knee measured by 0-10 NRS; assessments at each week until Week 24 compared to Baseline."}
  • {"endpoint_text":"- Change from Baseline to end of follow-up period (i.e. 12 weeks after the end of treatment) of the daily (24-hour) pain in the target knee as measured with the NRS;","definition_or_measurement_approach":"Daily (24-hour) pain in the target knee measured by 0-10 NRS; change from Baseline to end of follow-up (12 weeks post-treatment)."}
  • {"endpoint_text":"- Responder rates at each visit using 2 different response definitions (≥ 30% or ≥ 50% decrease versus Baseline in weekly mean of the average daily (24-hour) NRS pain intensity score);","definition_or_measurement_approach":"Proportion of responders per visit defined as ≥30% or ≥50% decrease from Baseline in weekly mean average daily (24-hour) NRS pain score."}
  • {"endpoint_text":"- Change from Baseline to Weeks 4, 12 and 24 in mean WOMAC® total score and all mean WOMAC® subscores (except for the primary endpoint change from Baseline to Week 24 in mean score of WOMAC® function subscale);","definition_or_measurement_approach":"Change from Baseline at Weeks 4, 12, 24 in WOMAC® total score and WOMAC® subscores (measured per WOMAC instrument)."}
  • {"endpoint_text":"- Change from Baseline to Weeks 4, 12 and 24 in patient’s quality of life (EQ-5D-5L);","definition_or_measurement_approach":"Change from Baseline at Weeks 4, 12, 24 in EQ-5D-5L scores (patient-reported quality of life instrument)."}
  • {"endpoint_text":"- Patient’s global evaluation at Weeks 4, 12, and 24 as measured by PGIC using a 5-point rating scale;","definition_or_measurement_approach":"Patient Global Impression of Change (PGIC) assessed at Weeks 4, 12, 24 using a 5-point scale."}
  • {"endpoint_text":"- Investigator’s global evaluation at Weeks 4, 12 and 24 as measured by CGIC using a 5-point rating scale;","definition_or_measurement_approach":"Clinician/Investigator Global Impression of Change (CGIC) assessed at Weeks 4, 12, 24 using a 5-point scale."}
  • {"endpoint_text":"- Consumption of rescue medication (paracetamol), including the number and proportion of users, the number of daily intakes and total dose per day.","definition_or_measurement_approach":"Use of rescue medication (paracetamol): number and proportion of users, number of daily intakes, and total daily dose recorded."}

Recruitment

Planned Sample Size
520
Recruitment Window Months
12
Consent Approach
Written informed consent is required: "Voluntarily given informed consent to study participation in writing encompassing consent to personal data processing;" Subject information and informed consent forms are provided (documents available in Czech, Hungarian and Polish according to country-specific materials). No assent process specified (adult participants ≥50 years).

Geography

Total Number Of Sites
31
Total Number Of Participants
520

Czechia

Earliest CTIS Part Ii Submission Date
07-01-2025
Latest Decision Or Authorization Date
23-02-2026
Processing Time Days
412
Number Of Sites
10
Number Of Participants
150

Sites

Site Name
ORTOPEDICKÁ AMBULANCE, MUDr. Jiří Štědrý, Ph.D.
Principal Investigator Name
Martin Slávik
Principal Investigator Email
rosiggnol@seznam.cz
Contact Person Name
Martin Slávik
Contact Person Email
rosiggnol@seznam.cz
Site Name
Artroscan s.r.o.
Principal Investigator Name
Ladislav Bortlík
Principal Investigator Email
bormed@bormed.cz
Contact Person Name
Ladislav Bortlík
Contact Person Email
bormed@bormed.cz
Site Name
Medical Plus s.r.o.
Principal Investigator Name
Eva Dokoupilová
Principal Investigator Email
eva.dokoupil@gmail.com
Contact Person Name
Eva Dokoupilová
Contact Person Email
eva.dokoupil@gmail.com
Site Name
MuDr. Halada s.r.o.
Principal Investigator Name
Filip Halada
Principal Investigator Email
filip.halada@seznam.cz
Contact Person Name
Filip Halada
Contact Person Email
filip.halada@seznam.cz
Site Name
Ortopedie MUDr. David Knourek s.r.o.
Principal Investigator Name
David Kňourek
Principal Investigator Email
info@ortopediecheb.cz
Contact Person Name
David Kňourek
Contact Person Email
info@ortopediecheb.cz
Site Name
ESTETICKE a LASEROVE CENTRUM s.r.o.
Principal Investigator Name
Jarmila Voběrková
Principal Investigator Email
astavob@seznam.cz
Contact Person Name
Jarmila Voběrková
Contact Person Email
astavob@seznam.cz
Site Name
Ortopedie a traumatologie MUDr. Reiter s.r.o.
Principal Investigator Name
Josef Reiter
Principal Investigator Email
josef.reiter@seznam.cz
Contact Person Name
Josef Reiter
Contact Person Email
josef.reiter@seznam.cz
Site Name
Ortopedicko-traumatologická ambulance
Principal Investigator Name
Renáta Doležalová
Principal Investigator Email
ortopedie.dolezalova@centrum.cz
Contact Person Name
Renáta Doležalová
Site Name
EUC Klinika Praha a.s.
Department Name
Ortopedická ambulance
Principal Investigator Name
Zdenĕk Stĕpánek
Principal Investigator Email
zdenek.stepanek@tiscali.cz
Contact Person Name
Zdenĕk Stĕpánek
Contact Person Email
zdenek.stepanek@tiscali.cz
Site Name
Revmatologicky Ustav
Principal Investigator Name
Karel Pavelka
Principal Investigator Email
pavelka@revma.cz
Contact Person Name
Karel Pavelka
Contact Person Email
pavelka@revma.cz

Hungary

Earliest CTIS Part Ii Submission Date
13-02-2025
Latest Decision Or Authorization Date
09-02-2026
Processing Time Days
361
Number Of Sites
10
Number Of Participants
160

Sites

Site Name
University Of Debrecen
Department Name
Department of Sports Medicine
Principal Investigator Name
Sándor Szántó
Principal Investigator Email
szanto.sandor@med.unideb.hu
Contact Person Name
Sándor Szántó
Contact Person Email
szanto.sandor@med.unideb.hu
Site Name
Kistarcsai Flor Ferenc Korhaz
Department Name
Department of Rheumatology and Physiotherapy
Principal Investigator Name
Edit Tóth
Principal Investigator Email
toth.edit@florhosp.hu
Contact Person Name
Edit Tóth
Contact Person Email
toth.edit@florhosp.hu
Site Name
Vital-Medicina Kft.
Principal Investigator Name
Edit Drescher
Principal Investigator Email
dr.dreschere@gmail.com
Contact Person Name
Edit Drescher
Contact Person Email
dr.dreschere@gmail.com
Site Name
Ortho-Cons Bt.
Principal Investigator Name
Gyula Szikora
Principal Investigator Email
szikora.gyula@icloud.com
Contact Person Name
Gyula Szikora
Contact Person Email
szikora.gyula@icloud.com
Site Name
Shawfar-Med Kft.
Principal Investigator Name
Adel Shawfar
Principal Investigator Email
shawfarmed@gmail.com
Contact Person Name
Adel Shawfar
Contact Person Email
shawfarmed@gmail.com
Site Name
Reumafaktor Bt.
Principal Investigator Name
Csaba Kovács
Principal Investigator Email
drcsab8@yahoo.com
Contact Person Name
Csaba Kovács
Contact Person Email
drcsab8@yahoo.com
Site Name
Lab-Med Bt.
Principal Investigator Name
Endre Lénárt
Principal Investigator Email
lenartendre@gmail.com
Contact Person Name
Endre Lénárt
Contact Person Email
lenartendre@gmail.com
Site Name
RH Medical Kft.
Principal Investigator Name
Henrik Rybaltovszki
Principal Investigator Email
rybaltovszki.henrik@med.unideb.hu
Contact Person Name
Henrik Rybaltovszki
Site Name
Szerapiszmed Kft.
Principal Investigator Name
György Gruber
Principal Investigator Email
gruber.gy@gmail.com
Contact Person Name
György Gruber
Contact Person Email
gruber.gy@gmail.com
Site Name
Ortho-Cons Bt. (additional site listing)
Principal Investigator Name
Gyula Szikora
Principal Investigator Email
szikora.gyula@icloud.com
Contact Person Name
Gyula Szikora
Contact Person Email
szikora.gyula@icloud.com

Poland

Earliest CTIS Part Ii Submission Date
12-03-2025
Latest Decision Or Authorization Date
09-02-2026
Processing Time Days
334
Number Of Sites
11
Number Of Participants
210

Sites

Site Name
Farma-Med Kujawskie Centrum Medyczne Sp. z o.o.
Principal Investigator Name
Artur Szumlanski
Principal Investigator Email
szuart@poczta.onet.pl
Contact Person Name
Artur Szumlanski
Contact Person Email
szuart@poczta.onet.pl
Site Name
Ortotrauma Sp. z o.o.
Principal Investigator Name
Jan Skowroński
Principal Investigator Email
ortoskow@gmail.com
Contact Person Name
Jan Skowroński
Contact Person Email
ortoskow@gmail.com
Site Name
eMKa MED Centrum Medyczne
Principal Investigator Name
Maciej Kentel
Principal Investigator Email
emkamed.cm@gmail.com
Contact Person Name
Maciej Kentel
Contact Person Email
emkamed.cm@gmail.com
Site Name
Rehasport Clinic Sp. z o.o.
Principal Investigator Name
Paweł Bąkowski
Principal Investigator Email
drpawelbakowski@gmail.com
Contact Person Name
Paweł Bąkowski
Contact Person Email
drpawelbakowski@gmail.com
Site Name
Szpital Specjalistyczny Im. Ludwika Rydygiera W Krakowie Sp. z o.o.
Department Name
Department of Orthopedics and Traumatology of the Locomotor System
Principal Investigator Name
Grzegorz Kwiatkowski
Principal Investigator Email
kwiatkowskigrzegorz@gmail.com
Contact Person Name
Grzegorz Kwiatkowski
Contact Person Email
kwiatkowskigrzegorz@gmail.com
Site Name
Centrum Medyczne MBB-MED, Marta Blach Burek
Principal Investigator Name
Jarosław Bigaj
Principal Investigator Email
jaroslawbigaj@mbbmed.com
Contact Person Name
Jarosław Bigaj
Contact Person Email
jaroslawbigaj@mbbmed.com
Site Name
Orto-Optymist Joanna Gawda Piotr Gawda Sp.p. Lekarzy
Principal Investigator Name
Piotr Gawda
Principal Investigator Email
piogawda@gmail.com
Contact Person Name
Piotr Gawda
Contact Person Email
piogawda@gmail.com
Site Name
Zespol Opieki Zdrowotnej W Boleslawcu
Principal Investigator Name
Mirosław Kulej
Principal Investigator Email
mirek.kulej@interia.pl
Contact Person Name
Mirosław Kulej
Contact Person Email
mirek.kulej@interia.pl
Site Name
Mikomed Sp. z o.o.
Principal Investigator Name
Jacek Mikosiński
Principal Investigator Email
mikomed@mikomed.pl
Contact Person Name
Jacek Mikosiński
Contact Person Email
mikomed@mikomed.pl
Site Name
Skladowa Zdrowia Sp. z o.o.
Principal Investigator Name
Andrzej Grzegorzewski
Principal Investigator Email
andrzejgr@op.pl
Contact Person Name
Andrzej Grzegorzewski
Contact Person Email
andrzejgr@op.pl
Site Name
Centrum Diagnostyki Medycznej Multi-Med S.A.
Principal Investigator Name
Grzegorz Sawicki
Principal Investigator Email
jolanta.waloch@multimed.pl
Contact Person Name
Grzegorz Sawicki
Contact Person Email
jolanta.waloch@multimed.pl

Sponsor

Primary sponsor

Full Name
IBSA Institut Biochimique SA
Organisation Type
Pharmaceutical company
Country Of Registered Address
Switzerland

Investigational products

Investigational Product Name
CONDROSULF 800 mg tabletta
Active Substance
CHONDROITIN SULFATE SODIUM
Modality
Other
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Authorised (marketing authorisation information present; marketingAuthNumber OGYI-T-04484/04 in Hungary)
Starting Dose
800 mg
Dose Levels
800 mg
Maximum Dose
800 mg
Investigational Product Name
Chondroitin sulfate (marine) 800 mg tablet
Active Substance
CHONDROITIN SULFATE (MARINE)
Modality
Other
Routes Of Administration
ORAL
Route
ORAL
Authorisation Status
Not specified (comparator product entry present in trial data)
Starting Dose
800 mg
Dose Levels
800 mg
Maximum Dose
800 mg

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