AMG0103 in Subjects With Chronic Discogenic Lumbar Back Pain

Study Purpose

This clinical trial evaluate the safety, tolerability and exploratory efficacy of targeted single injection of AMG0103 in subject with chronic discogenic lumbar back pain

Recruitment Criteria

Accepts Healthy Volunteers

Healthy volunteers are participants who do not have a disease or condition, or related conditions or symptoms

No
Study Type

An interventional clinical study is where participants are assigned to receive one or more interventions (or no intervention) so that researchers can evaluate the effects of the interventions on biomedical or health-related outcomes.


An observational clinical study is where participants identified as belonging to study groups are assessed for biomedical or health outcomes.


Searching Both is inclusive of interventional and observational studies.

Interventional
Eligible Ages 18 Years - 75 Years
Gender All
More Inclusion & Exclusion Criteria

Inclusion Criteria:

1. Male or female, between 18 and 75 years of age, inclusive, and skeletally mature, in the opinion of the investigator. 2. Has provided written informed consent before undergoing any study-specific procedures. 3. Has chronic low back pain for at least 6 months, where back pain is greater than leg pain. 4. Has separate low back pain and leg pain VAS scores within the following parameters: 1. Average low back pain VAS score of at least 40 mm and less than 90 mm on a 100 mm visual analog scale. 2. Average leg pain VAS score that is less than or equal to 50% of the average low back pain VAS score above, where leg pain VAS scores are measured on a 100 mm visual analog scale. 5. Has had inadequate response to conservative medical care over a period of at least 3 months. 6. Diagnosis of painful degenerative disc disease at one lumbar level from L1 to S1 confirmed by subject history and radiographic studies (eg, MRI, x-rays). Radiographic studies must demonstrate the following: 1. A Pfirrmann score of 3 or 4 on MRI in just a single disc between L1 and S1 2. With or without contained disc herniations of <3 mm protrusion with no radiographic evidence of neurologic compression 3. Disc height loss of the symptomatic disc is less than 50% of the adjacent discs 4. All discs other than the index disc must have a Pfirrman score of less than 3 5. No spondylolisthesis or instability on flexion/extension views of more than 1-2 mm 6. No evidence of sacroiliac, or extra-spinal, pathology that could account for lumbar back pain 7. No more fluid in, or widening of, the facet joints around the symptomatic disc than is seen on the other facet joints of "normal" levels 7. Has a Body Mass Index (BMI) between 15.0 and 35.0 kg/m2 at the screening visit. 8. Oswestry Disability Index score of at least 30 and not more than 90 on the 100 point questionnaire. 9. Willing and able to comply with all protocol requirements. 10. Females of childbearing potential must agree to use highly effective methods of contraception during heterosexual intercourse from the date they sign the ICF until 1 year after the single dose of study drug is administered. 11. Male subjects must agree that, if their partner is of childbearing potential, they and the partner will use an appropriate method of contraception as defined above.

Exclusion Criteria:

1. Has any prior or current medical condition (eg, an active systemic infection), including known bleeding disorders that, in the judgment of the Investigator, would prevent the subject from safely participating in and/or completing all study requirements. 2. Has any clinically significant finding on a screening evaluation that in the judgment of the Investigator would preclude safe study completion. 3. Liver function tests >1.5 the upper limit of normal (ULN) for alkaline phosphatase, alanine aminotransferase (ALT), aspartate aminotransferase (AST) 4. Serum creatinine >1.5 ULN at screening 5. Blood pressure >160/110 mm Hg recorded on 3 readings at screening and/or resting pulse >120 beats/min at screening 6. Body temperature ≥101°F on day of planned injection 7. Has a co-morbid medical condition of the spine or the upper extremities that may affect neurological and/or pain assessments as specified in the protocol, including spinal fusion, spondylolysis and spondylolisthesis. 8. Has evidence of hip pathology based on clinical history, physical exam and/or radiographic imaging that could be the source of lumbar back pain. 9. Has a history of an endocrine or metabolic disorder that affects the spine (eg, Paget's disease). 10. Has a compressive pathology due to stenosis or frankly herniated disc or sequestered discs. 11. Has symptomatic involvement of more than one lumbar disc, in the opinion of the investigator. 12. Has an intact disc bulge/protrusion or focal herniation at the symptomatic level >3 mm, the presence of disc extrusion or sequestration, or a complete annular tear. 13. Has lumbar intervertebral foraminal stenosis at the symptomatic level resulting in clinically significant spinal nerve root compression, in the opinion of the investigator. 14. Has undergone a previous surgery at the symptomatic disc, or has plans to do so within 6 months of receiving the dose of AMG0103, that has altered the structure of the target disc level, or is likely to do so (eg, laminectomy, foraminotomy, fusion, intradiscal electrothermal therapy, intradiscal radiofrequency, thermocoagulation). 15. Has had any lumbar intradiscal injection procedure (eg, injection of corticosteroids, methylene blue, dextrose, or glucosamine and chondroitin sulfate). Discography may be performed, but must be done at least 3 weeks (or more) prior to the injection procedure in this study. 16. Has had any epidural steroid injection(s) within 3 months prior to study treatment. 17. Is a female who is pregnant, planning to become pregnant, or lactating. 18. Has a PT(INR) and/or aPTT lab result outside of the reference range, or within the last 30 days taken, or is currently on, an anticoagulant therapy (e.g., Warfarin) for the purpose of treating or preventing blood clots. 19. Has ferromagnetic implants that would disallow MRI of the symptomatic disc. 20. Is involved in current or pending spinal litigation where permanent disability benefits are being sought. 21. Has a physical or mental condition (eg, senile dementia, Alzheimer's disease) that would interfere with Subject self-assessment of function, pain or quality of life. 22. Has a positive screen for Hepatitis B Surface Antigen, Hepatitis C antibodies, or human immunodeficiency virus (HIV) by antibodies or nucleic acid test. 23. Is an immediate family member (by birth) of any other subject participating in this study. 24. Has a history of cancer that does NOT have documentation to support a complete and curative treatment. 25. Has participated within the previous 3 months in an interventional clinical study or is concurrently enrolled in any non-interventional research of any type judged to be scientifically or medically incompatible with this study. 26. Is transient or has been treated in the 6 months prior to providing informed consent for alcohol and/or drug abuse in an inpatient substance abuse program. 27. Is currently incarcerated (a prisoner). 28. Is an Investigator-site employee or immediate family (defined as a spouse, parent, child, or sibling, whether biological or legally adopted) of an Investigator-site employee. 29. Is a Sponsor employee (permanent, temporary contract worker, or designee responsible for the conduct of the study) or immediate family (defined as a spouse, parent, child, or sibling, whether biological or legally adopted) of a Sponsor employee.

Trial Details

Trial ID:

This trial id was obtained from ClinicalTrials.gov, a service of the U.S. National Institutes of Health, providing information on publicly and privately supported clinical studies of human participants with locations in all 50 States and in 196 countries.

NCT03263611
Phase

Phase 1: Studies that emphasize safety and how the drug is metabolized and excreted in humans.

Phase 2: Studies that gather preliminary data on effectiveness (whether the drug works in people who have a certain disease or condition) and additional safety data.

Phase 3: Studies that gather more information about safety and effectiveness by studying different populations and different dosages and by using the drug in combination with other drugs.

Phase 4: Studies occurring after FDA has approved a drug for marketing, efficacy, or optimal use.

Phase 1
Lead Sponsor

The sponsor is the organization or person who oversees the clinical study and is responsible for analyzing the study data.

AnGes, Inc.
Principal Investigator

The person who is responsible for the scientific and technical direction of the entire clinical study.

AnGes, Inc. Clinical Development
Principal Investigator Affiliation AnGes, Inc.
Agency Class

Category of organization(s) involved as sponsor (and collaborator) supporting the trial.

Industry
Overall Status Recruiting
Countries United States
Conditions

The disease, disorder, syndrome, illness, or injury that is being studied.

Degenerative Disc Disease
Additional Details

This is a Phase 1b, multicenter, double-blind, single ascending dose study designed to evaluate the safety of AMG0103 in adult male and female subjects with chronic discogenic lumbar back pain. This protocol anticipates that 8 subjects with symptomatic single level discogenic pain will be enrolled in each of up to 3 dose-escalation cohorts. Subjects in each cohort will receive AMG0103 or Placebo as a targeted, single, intradiscal injection.

Arms & Interventions

Arms

Placebo Comparator: placebo

subject will receive single intradiscal injection of placebo

Experimental: AMG0103 low dose

subject will receive single intradiscal injection of AMG0103 low dose

Experimental: AMG0103 middle dose

subject will receive single intradiscal injection of AMG0103 middle dose

Experimental: AMG0103 high dose

subject will receive single intradiscal injection of AMG0103 high dose

Interventions

Drug: - Placebo

single intradiscal injection

Drug: - AMG0103

single intradiscal injection

Contact a Trial Team

If you are interested in learning more about this trial, find the trial site nearest to your location and contact the site coordinator via email or phone. We also strongly recommend that you consult with your healthcare provider about the trials that may interest you and refer to our terms of service below.

Keck Medicine of USC, Los Angeles, California

Status

Recruiting

Address

Keck Medicine of USC

Los Angeles, California, 90033

Site Contact

Emily Ananthset

[email protected]

323-442-5881

University of California San Diego, San Diego, California

Status

Recruiting

Address

University of California San Diego

San Diego, California, 92037

Site Contact

Jesal Parekh

[email protected]

858-822-1288

Spine Institute of San Diego, San Diego, California

Status

Recruiting

Address

Spine Institute of San Diego

San Diego, California, 92120

Site Contact

Katherine West

[email protected]

770-365-2555

Florida Medical Pain Management, Saint Petersburg, Florida

Status

Recruiting

Address

Florida Medical Pain Management

Saint Petersburg, Florida, 33709

Site Contact

Amanda Green

[email protected]

407-414-1936 #280

Florida Medical Relief, Tampa, Florida

Status

Recruiting

Address

Florida Medical Relief

Tampa, Florida, 33614

Site Contact

Carlos Bussey

[email protected]

727-510-9773

Rush University Medical Center, Chicago, Illinois

Status

Recruiting

Address

Rush University Medical Center

Chicago, Illinois, 60612

Site Contact

Susan Dvojack

[email protected]

312-942-6689