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Trial registered on ANZCTR
Registration number
ACTRN12617000893303
Ethics application status
Approved
Date submitted
14/06/2017
Date registered
19/06/2017
Date last updated
18/06/2021
Date data sharing statement initially provided
8/04/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
A pilot study to investigate the effects of pentosan polysulfate sodium in Ross River virus induced arthralgia
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Scientific title
A pilot study to investigate the effects of pentosan polysulfate sodium in Ross River virus induced arthralgia
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Secondary ID [1]
291932
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none
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Universal Trial Number (UTN)
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Trial acronym
PARA_004
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ross River Virus induced arthralgia
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Condition category
Condition code
Musculoskeletal
302692
302692
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0
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Other muscular and skeletal disorders
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Inflammatory and Immune System
302693
302693
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0
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Other inflammatory or immune system disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Arm 1: Pentosan polysulfate sodium for injection, 100 mg/ml.
Arm 2: 0.9% NaCl for injection.
Treatment (active or placebo) will be administered by sub-cutaneous injection, in a randomised, double blinded manner by trained clinical trial staff at clinical trial sites, in a ratio of 2:1 active:placebo.
Drug accountability logs will be maintained and monitored throughout the study.
The dosage regime is 2mg/kg (or equivalent volume of placebo) by subcutaneous injection, twice weekly, for 6 weeks.
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Intervention code [1]
298054
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Treatment: Drugs
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Comparator / control treatment
Placebo control 0.9% NaCl for injection
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Treatment-emergent adverse events (TEAEs) including Serious Adverse Events (SAEs), collected by symptoms reported in response to questioning at each visit (twice weekly), clinically significant laboratory abnormalities, physical examination findings.
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Assessment method [1]
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Timepoint [1]
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Day 1 of Treatment to end of study (day 81)
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Primary outcome [2]
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Safety - Changes in blood results (haematology panel including Haemoglobin, haematocrit, red blood cell count, differential white blood cell count, platelet count, mean corpuscular haemoglobin, mean corpuscular volume, mean corpuscular haemoglobin concentration)
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Assessment method [2]
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Timepoint [2]
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Day 1, 15, 29, 39 and 81
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Primary outcome [3]
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safety - Changes in blood results (biochemistry)
Glucose, sodium, potassium, chloride, bicarbonate, calcium creatinine, urea, uric acid, amylase, lipase, triglyceride, cholesterol, total protein, lactate dehydrogenase, creatinine kinase, C-reactive protein, albumin, phosphate, Aspartate aminotransferase, Alanine aminotransferase, gamma-glutamyl transferase, alkaline phosphatase, conjugated bilirubin, total bilirubin.
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Assessment method [3]
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Timepoint [3]
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Day 1, 39 and 81
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Secondary outcome [1]
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Change from baseline in patient assessed Quality of Life scores as assessed by SF-36 scores
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Assessment method [1]
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Timepoint [1]
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Day 1, 15, 29, 39 and 81
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Secondary outcome [2]
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Change from baseline in RAPID 3 scores (self assessed patient questionnaire to assess joint symptoms)
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Assessment method [2]
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Timepoint [2]
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Day 1, 15, 29, 39 and 81
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Secondary outcome [3]
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Change from baseline in pain intensity score as assessed by the Numeric Rating Scale (NRS) for pain
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Assessment method [3]
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Timepoint [3]
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Day 1, 15, 29, 39 and 81
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Secondary outcome [4]
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Changes in Coagulation (measured by APTT and INR)
(Primary outcome)
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Assessment method [4]
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Timepoint [4]
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Day 1, 15, 29, 39, 81
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Eligibility
Key inclusion criteria
1. Males and females aged 18 - 65 years (inclusive)
2. Diagnosis of Ross River virus infection based on laboratory definitive or laboratory suggestive diagnosis according to Australian Government Ross River virus case definition
3. Current Ross River virus symptoms including a minimum of 2 joints involved (swollen and/or tender joint on examination)
4. Medically documented onset of RRV infection symptoms minimum 12 weeks and maximum 52 weeks prior to Day 1
5. Able to speak, read and understand English sufficiently to understand the purposes and risks of the study and to provide written informed consent
6. If applicable, subjects must be willing to comply with the medically acceptable contraceptive requirements of the study from Screening to at least 28 days after the last IMP administration
7. Body Mass Index (BMI) of 18.0 to 35.0 kg/m2 (inclusive)
Subjects must be willing and able to comply with all scheduled visits, treatment plan, laboratory tests and other study procedures
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
1. Documented or reported bleeding tendency with anticoagulant or antiplatelet drugs
2. Current treatment with anticoagulants or antiplatelet drugs
3. Subject taking any current or recent medication specified as per Prohibited Medications for this study.
4. Subject unwilling to withhold paracetamol and alcohol for 24 hours prior to study assessment visits
5. Any clinically significant abnormalities not related to RRV infection on clinical chemistry, haematology, urinalysis, physical examination, medical history, 12-lead ECG, or vital signs as judged by the investigator or sponsor (at Screening and/or Day 1)
6. Coagulation parameters or platelets outside normal range at Screening and/or Day 1
7. Evidence of any active or clinically significant chronic condition including autoimmune disease involving the musculoskeletal system
8. Current evidence or recent history of other arthrogenic virus infection
9. Blood or plasma donation of more than 500 mL during the 3 months prior to Day 1
10. Currently hospitalised or any planned hospitalisations during the study period
11. Participation in another clinical trial or administration of any investigational agent within 8 weeks or 5 half-lives (whichever is longer) prior to Day 1
12. Currently active or recent history (within previous 12 months) of a gastric or duodenal ulcer, or suspicion of alimentary tract bleeding
13. History of significant hypersensitivity to PPS or drugs of a similar chemical or pharmacological class, including a history of heparin induced thrombocytopenia
14. Females who are breast feeding, pregnant or planning to become pregnant during participation in the study
15. Major surgery within 3 months prior to Day 1 or anticipated surgery in the study period
16. History of or current clinically-significant gastrointestinal, hepatic, renal, cardiovascular, respiratory, endocrine, oncological, immunological, neurological, ophthalmological, haematological or psychiatric disorder or any other condition, which in the opinion of the investigator or sponsor would jeopardize the safety of the subject or the validity of the study results
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Central randomisation by phone/computer
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people receiving the treatment/s
The people administering the treatment/s
The people assessing the outcomes
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Intervention assignment
Parallel
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
No formal statistical sample size estimation has been performed due to the exploratory nature of this study. Sample size is based on clinical and practical considerations.
The descriptive summary for the categorical variables will include counts and percentages. The descriptive summary for the continuous variables will include number of subjects (n), means, medians, standard deviations, and minimum and maximum values. All data will be listed for all subjects.
This study is descriptive in nature, and no formal hypothesis testing will be performed. Any confidence intervals (CIs) generated will be 95%, unless stated otherwise.
All data will be listed for all subjects. All statistical analyses will be performed using SAS unless otherwise stated.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
20/07/2017
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Actual
7/08/2017
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Date of last participant enrolment
Anticipated
1/06/2018
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Actual
13/08/2018
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Date of last data collection
Anticipated
20/11/2018
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Actual
5/11/2018
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Sample size
Target
24
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Accrual to date
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Final
20
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Recruitment in Australia
Recruitment state(s)
QLD,VIC
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Recruitment hospital [1]
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Mater Adult Hospital - South Brisbane
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Recruitment hospital [2]
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Barwon Health - Geelong Hospital campus - Geelong
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Recruitment hospital [3]
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Rich River Health Group - Echuca
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Recruitment hospital [4]
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Griffith University Clinical Trials Unit - Southport
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Recruitment hospital [5]
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Sunshine Coast Clinical Research - Noosa Heads
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Recruitment postcode(s) [1]
16178
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4101 - South Brisbane
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Recruitment postcode(s) [2]
16531
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3220 - Geelong
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Recruitment postcode(s) [3]
17874
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3564 - Echuca
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Recruitment postcode(s) [4]
17875
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4215 - Southport
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Recruitment postcode(s) [5]
22236
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4567 - Noosa Heads
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Funding & Sponsors
Funding source category [1]
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Commercial sector/Industry
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Name [1]
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Paradigm Biopharmaceuticals
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Address [1]
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Level 2, 517 Flinders Lane
Melbourne
VIC 3000
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Country [1]
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Australia
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Primary sponsor type
Commercial sector/Industry
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Name
Paradigm Biopharmaceuticals
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Address
Level 2, 517 Flinders Lane
Melbourne
VIC 3000
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Country
Australia
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Secondary sponsor category [1]
295391
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None
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Name [1]
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Address [1]
295391
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Country [1]
295391
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Bellberry Human Research Ethics Committee B
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Ethics committee address [1]
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129 Glen Osmond Road Eastwood South Australia 5063
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Ethics committee country [1]
297670
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Australia
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Date submitted for ethics approval [1]
297670
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05/04/2017
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Approval date [1]
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12/05/2017
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Ethics approval number [1]
297670
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2017-03-235
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Summary
Brief summary
This will be a double blind randomised placebo controlled study in 24 subjects with Ross River virus induced arthralgia. Rationale PPS is a semi-synthetic heparin like macromolecular carbohydrate that resembles glycosaminoglycans. It has been widely used for its anti-inflammatory and regenerative properties in the treatment of interstitial cystitis. PPS also has fibrinolytic, lipolytic, and anticoagulant properties and is used for the treatment of thromboembolic prophylaxis in Europe. In Germany and Hungary, PPS is also approved in oral and injectable form for the treatment of peripheral arterial occlusive disease. In a recent study in mice with Ross River virus induced joint disease, PPS administered for 10 days post infection significantly reduced the severity of joint symptoms, with reductions in joint swelling, inflammation in joints and muscle, and serum levels of mediators of inflammation which are implicated in the disease. PPS treatment also demonstrated a joint cartilage protective effect, with preservation of the thickness and structure of the joint cartilage. On the basis of this research, Paradigm intends to evaluate the safety and efficacy of PPS treatment in human patients affected by joint symptoms following Ross River viral infection The main inclusion criteria for the study will be: 1. Males and females aged 18 to 65 years (inclusive) 2. Diagnosis of Ross River virus infection based on laboratory definitive or laboratory suggestive diagnosis 3. Current Ross River virus symptoms including a minimum 2 joints involved 4. The onset of RRV infection symptoms minimum 12 weeks and maximum 52 weeks prior to Day 1 Treatment Intervention Patients will be randomised 2;1 to receive either PPS or placebo respectively. Dose schedule: 2 mg/kg administered by subcutaneous injection twice weekly for 6 weeks. Treatments will be given by medically qualified site staff, and patients will be evaluated and monitored at the regular visits during the study. Objectives The primary objective will be to evaluate the safety and tolerability of subcutaneous pentosan polysulfate sodium (PPS) in subjects with Ross River virus (RRV
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Paul Griffin
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Address
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RIO Research unit, Mater Misericordiae Ltd
Level 3, Aubigny Place, Raymond Terrace
South Brisbane QLD 4101
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Country
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Australia
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Phone
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+61 402 077 302
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Melanie Duiker
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Address
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Project Manager
Paradigm BioPharmaceuticals
Level 2, 517 Flinders Lane, Melb, VIC, 3000, AUSTRALIA
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Country
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Australia
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Phone
74759
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+61 492922860
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Fax
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Email
74759
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[email protected]
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Contact person for scientific queries
Name
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Ravi Krishnan
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Address
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Paradigm biopharmaceuticals
Level 2, 517 Flinders Lane
Melbourne
VIC 3000
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Country
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Australia
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Phone
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+61 492922860
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Fax
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Email
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
Source
Title
Year of Publication
DOI
Embase
Pentosan polysulfate sodium for Ross River virus-induced arthralgia: a phase 2a, randomized, double-blind, placebo-controlled study.
2021
https://dx.doi.org/10.1186/s12891-021-04123-w
N.B. These documents automatically identified may not have been verified by the study sponsor.
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