Protocol summary

Summary
This study is a randomized controlled trial on 60 human subjects with grade 2 and 3 knee osteoarthritis (according to plain radiography) who will be enrolled according to inclusion and exclusion criteria. Patients will be randomly distributed into 4 groups of 15 patients. The initial MRI will be performed for all patients and the patients will be treated as follow: 1) intra-articular injection of mesenchymal cells or MSCs (treatment group) that are isolated from the abdominal wall adipose tissue 2) intra-articular injection of platelet-rich plasma or PRP (treatment group) that are extracted from 100 mL of peripheral blood 3) Intra-articular injection of MSCs in PRP-rich medium (treatment group) and 4) intra-articular injection of hyaluronic acid (control group) which is commercially available. Patients’ follow-ups will be at month 1, 3, 6 and 12 post-treatment. At each follow-up, a clinical examination including range of motion and crepitus of the knee as well as an assessment of patient's health with KOOS (Knee injury and Osteoarthritis Outcome Score) questionnaire and NRS (Numerical Rating Scale) will be performed. Another MRI (second MRI) and a plain standing radiograph of the knee (second radiograph) at 6th month post-injection will be done and the results will be read according to MOAKS (Magnetic resonance imaging Osteoarthritis Knee Score) and K&L (Kellgren and Lawrence) scales. Following the last follow-up, the collected data will be compared and analyzed in a way that firstly, the findings of each patient in each group before and after the intervention will be independently compared, and secondly, the results of each group will be compared with the other three groups.

General information

Acronym
S
IRCT registration information
IRCT registration number: IRCT2012080510507N1
Registration date: 2014-06-01, 1393/03/11
Registration timing: registered_while_recruiting

Last update:
Update count: 0
Registration date
2014-06-01, 1393/03/11
Registrant information
Name
Zhaleh Shariati Sarabi
Name of organization / entity
Department of Internal Medicicince, Imam Reza Hospital
Country
Iran (Islamic Republic of)
Phone
+98 51 1802 2370
Email address
shariatij@mums.ac.ir
Recruitment status
Recruitment complete
Funding source
Mashhad University of Medical Sciences
Expected recruitment start date
2013-08-23, 1392/06/01
Expected recruitment end date
2015-08-23, 1394/06/01
Actual recruitment start date
empty
Actual recruitment end date
empty
Trial completion date
empty
Scientific title
Evaluation of efficacy of treatment with stem cells (SCs) and platelet-rich plasma (PRP) in patients with knee osteoarthritis
Public title
Evaluation of efficacy of treatment with stem cells (SCs) and platelet-rich plasma (PRP) in patients with knee arthrosis
Purpose
Treatment
Inclusion/Exclusion criteria
INCLUSION CRITERIA: Female or male patient with knee osteoarthritis based on the ACR criteria and knee radiography; Grade 2 or 3 osteoarthritis according to Kellgren and Lawrence grading scale; 45 < Patient’s Age< 75; Signed informed consent; No consumption of glucocorticoids, anti-inflammatory and immunomodulatory medications one week prior to the treatment; No history of previous participating in clinical trials on treatment of osteoarthritis; No intra-articular injection of hyaluronic acid in the past 6 months EXCLUSION CRITERIA: Secondary osteoarthritis; Concurrent connective tissue disorder; Active neurological disease; Severe cardiac disease; Debilitating respiratory disease requiring constant treatment; Any endocrinopathy; Malignancies; Current infectious disease; Psychologic diseases (especially major depression) requiring treatment with antidepressants or related medications; Being under treatment with immunosuppressive or cytotoxic medications; Being under constant treatment with antithrombotic medications; History of allergy to biologic products; Hb < 11 g/dL; Plt < 120*103/μL
Age
From 40 years old to 75 years old
Gender
Both
Phase
N/A
Groups that have been masked
No information
Sample size
Target sample size: 60
Randomization (investigator's opinion)
Randomized
Randomization description
Blinding (investigator's opinion)
Double blinded
Blinding description
Placebo
Used
Assignment
Parallel
Other design features

Secondary Ids

empty

Ethics committees

1

Ethics committee
Name of ethics committee
Mashhad University of Medical Sciences
Street address
Daneshgah St.
City
Mashhad
Postal code
913791-3316
Approval date
2013-02-06, 1391/11/18
Ethics committee reference number
511/4436

Health conditions studied

1

Description of health condition studied
Knee Osteoarthritis
ICD-10 code
M17.0
ICD-10 code description
Primary gonarthrosis, bilateral

Primary outcomes

1

Description
Morphological characteristics of of articular cartilage
Timepoint
Before intervention, 6 months post-intervention, 12 months post-intervention
Method of measurement
MRI Osteoarthritis Knee Score (MOAKS)

2

Description
Pain
Timepoint
Before intervention, 1 month post-intervention, 3 months post-intervention, 6 months post-intervention, 12 months post-intervention
Method of measurement
Pain Numerical Scale Rating

3

Description
Symptoms and function of the affected knee
Timepoint
Before intervention, 1 month post-intervention, 3 months post-intervention, 6 months post-intervention, 12 months post-intervention
Method of measurement
Knee injury and Osteoarthritis Outcome Score (KOOS)

4

Description
Range of motion
Timepoint
Before intervention, 1 month post-intervention, 3 months post-intervention, 6 months post-intervention, 12 months post-intervention
Method of measurement
Angle with protractor

Secondary outcomes

empty

Intervention groups

1

Description
Intra-articular injection of 2 mL hyaluronan (scaffold) + 2 mL autologus mesenchymal stem cell (2-3 million) + 0.2 mL dexamethasone
Category
Treatment - Drugs

2

Description
Intra-articular injection of 2 mL hyaluronan (scaffold) + 2 mL autologus platelet rich plasma + 0.2 mL dexamethasone
Category
Treatment - Drugs

3

Description
Intra-articular injection of 2 mL hyaluronan (scaffold) + 2 mL autologus mesenchymal stem cell (2-3 million) + 2 mL autologus platelet rich plasma + 0.2 mL dexamethasone
Category
Treatment - Drugs

4

Description
Intra-articular injection of 2 mL hyaluronan + 0.2 mL dexamethasone
Category
Placebo

Recruitment centers

1

Recruitment center
Name of recruitment center
Imam Reza Hospital
Full name of responsible person
Dr. Tayebeh Asadi Sakhmareshi
Street address
Ibn Sina st.
City
Mashhad

2

Recruitment center
Name of recruitment center
Imam Reza Hospital
Full name of responsible person
Dr. Sara Jalali Jivan
Street address
Ibn Sina st.
City
Mashhad

Sponsors / Funding sources

1

Sponsor
Name of organization / entity
Immunology Research Center
Full name of responsible person
Dr. Mahmoud Mahmoudi
Street address
Immunology Research Center, Bu-Ali Research Institute, Bu-Ali Square,
City
Mashhad
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Immunology Research Center
Proportion provided by this source
Public or private sector
empty
Domestic or foreign origin
empty
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
empty

2

Sponsor
Name of organization / entity
Headquarter of Research and Application of Stem Cells
Full name of responsible person
Dr. Ali Ghasemi
Street address
Montaserieh Organ Transplantation Office, Golestan St., Imam Khomeini Ave.
City
Mashhad
Grant name
Grant code / Reference number
Is the source of funding the same sponsor organization/entity?
Yes
Title of funding source
Headquarter of Research and Application of Stem Cells
Proportion provided by this source
Public or private sector
empty
Domestic or foreign origin
empty
Category of foreign source of funding
empty
Country of origin
Type of organization providing the funding
empty

Person responsible for general inquiries

Contact
Name of organization / entity
Bu-Ali Research Institute
Full name of responsible person
Dr. Jalil Tavakol Afshari
Position
Immunologist
Other areas of specialty/work
Street address
Bu-Ali Square
City
Mashhad
Postal code
9196773117
Phone
+98 51 1711 2611
Fax
Email
TavakolAJ@mums.ac.ir
Web page address

Person responsible for scientific inquiries

Contact
Name of organization / entity
Department of Internal Medicine, Imam Reza Hospital
Full name of responsible person
Dr. Zhaleh Shariati Sarabi
Position
Rheumatologist
Other areas of specialty/work
Street address
Ibn Sina st.
City
Mashhad
Postal code
Phone
+98 51 1802 2370
Fax
Email
shariatij@mums.ac.ir; jshariati@yahoo.com
Web page address

Person responsible for updating data

Contact
Name of organization / entity
Medical Office
Full name of responsible person
Dr. Seyed Mostafa Monzavi
Position
Medical Doctor
Other areas of specialty/work
Street address
#24, 2nd Farhad St., Malekabad Blv.
City
Mashhad
Postal code
9185757779
Phone
+98 51 1768 2983
Fax
Email
seyedmostafamonzavi@gmail.com
Web page address

Sharing plan

Deidentified Individual Participant Data Set (IPD)
empty
Study Protocol
empty
Statistical Analysis Plan
empty
Informed Consent Form
empty
Clinical Study Report
empty
Analytic Code
empty
Data Dictionary
empty
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