ClinicalTrials.gg
CompletedNCT04636229Updated Oct 16, 2025

Efficacy of Amniotic Suspension Allograft in Patients With Osteoarthritis of the Knee

A Phase 3 interventional study of Amniotic Suspension Allograft and Placebo in Knee Osteoarthritis, sponsored by Organogenesis. Completed at 38 sites in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-10-16.

Sponsored by Organogenesis · Phase 3, Interventional, and Treatment

From the registry’s dates

  • Primary completion was Jul 2023, 3 years 3 months ago, and no results have been posted to the registry.
Phase
Phase 3
Study type
Interventional
Enrollment
516
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Where this study stands

Counted across the records on this site · 2026-11-13

Among 796 studies in Osteoarthritis, Knee with a site in United States — 109 open to participants now, 153 under way, 15 of them phase 3. Osteoarthritis, Knee · United States.

Enrollment
47th of 691
516 · median 72
Started
2020
with 53 others
Phase 3
76 of 796
6 open now
Registered
552nd of 796
by date

Among the 796 studies in Osteoarthritis, Knee with a site in United States, this one is the 47th largest by enrollment of the 691 interventional ones that give a count, is one of 54 that started in 2020, is one of 76 in phase 3, and was the 552nd registered.

Osteoarthritis, Knee

3,292 studies on the registry are indexed under Osteoarthritis, Knee; 621 are open to participants now.

Browse Osteoarthritis, Knee studies →

Open to participants now

109 of the 796 studies in Osteoarthritis, Knee with a site in United States are open now. Recruiting first, the newest first:

104 more — sign in →

All 109 open studies →

A study can be open while its sites in United States have not opened yet or have stopped. Only those recruiting at a site in United States →

Who these studies take

Of the 382 Osteoarthritis, Knee studies recruiting now, 176 (46%) set no upper age limit and 113 (30%) stop at 75 or younger; 19 take children under 18; 39 take healthy volunteers.

This study: 18 Years and older · all sexes · no healthy volunteers.

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02

Study summary

This study is being conducted to evaluate the efficacy and safety of ASA compared to placebo in the management of osteoarthritis (OA) symptoms of the knee.

Read the detailed description

This is a prospective, multicenter, randomized, double-blind, placebo-controlled Phase 3 study of ASA in patients with OA of the knee. Initially, 474 subjects are planned for inclusion in this study using a group sequential design with two interim analyses and a final analysis. Sample size re-estimation is planned at the second interim analysis. Based on conditional power, the maximum sample size may be increased to up to 700 patients. Patients will be randomly assigned in a 1:1 ratio to receive a single intra-articular (IA) injection of 2 mL of ASA (plus 2 mL of normal saline) or 4 mL of normal saline.

Patients will be screened after informed consent is obtained. Eligible patients will be randomized to receive a single IA injection on Day 1. They will have serial assessments of knee pain, function, and symptoms scores, as well as safety assessments for up to 52 weeks after administration of the study drug.

The planned sequence and maximum duration of the study periods will be as follows:

  • Screening: 2 weeks
  • Treatment: 1 day
  • Follow-up: 52 weeks

The maximum treatment duration for each patient is 1 day.

The maximum study duration for each patient is 54 weeks.

Efficacy will be assessed via Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responder rates.

Safety will be assessed via monitoring of adverse events (AEs), safety laboratory testing, vital signs, physical examination, and concomitant medication use.

An independent data monitoring committee (DMC) with a defined charter will review study data and make preliminary decisions relative to interim analyses.

The assessments that are used in this study are standard, and are generally recognized as reliable, accurate, and relevant.

No pediatric patients will be included as OA of the knee is an age-related disorder and rarely occurs in patients under the age of 18 years. The sponsor plans to submit a waiver for studies in all pediatric age subgroups.

03

Conditions studied

  • Knee Osteoarthritis

Keywords

  • Osteoarthritis
  • Knee
  • Arthritis
  • Joint Diseases
  • Musculoskeletal Diseases
  • Rheumatic Diseases
04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Males or females 18 years of age or older
  2. Diagnosis of OA of the knee by a combination of clinical and radiographic findings
  3. OA of the knee with Kellgren and Lawrence radiographic classification (Grade 2-4 inclusive) confirmed by posterior-anterior, weight-bearing, fixed flexion radiography with 10° caudal beam angulation. A specially designed positioning frame will be used to standardize the positioning for image acquisition.
  4. Patients who have failed to adequately respond for at least 6 months to at least 2 OA therapies that include conservative, non-pharmacological therapy and simple analgesics (e.g., acetaminophen); nonsteroidal anti-inflammatory drugs (NSAIDS); avoidance of activities that cause joint pain; exercise; weight loss; physical therapy; and removal of excess fluid from the knee
  5. Overall pain score over the previous 7 days of 11 or more on the WOMAC Pain scale.
  6. (BMI) \< 40 kg/m²
  7. If female, must be (for at least 2 years), surgically sterilized (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), sexually abstinent, or willing and able to use 2 methods of from Day 1 through 12 months after treatment
  8. Males who are not surgically sterile (vasectomy) for at least 6 months prior to screening must confirm their willingness to use adequate methods of contraception from Day 1 through 12 months after treatment
  9. Willing to agree not to use illicit drugs during the study, and to have illicit drug testing at screening and at later time points, if illicit drug use is suspected during the study
  10. Able to comply with study requirements and complete the full sequence of protocol-related procedures and evaluations, including post-hospitalization, out-patient, and follow-up visits
  11. Able to understand and provide written

Exclusion criteria

Exclusion Criteria:

  1. Use of pain medication (including NSAIDs and cannabidiol [CBD] oil) less than 15 days before treatment (acetaminophen allowed)
  2. Regular use of anticoagulants
  3. Symptoms of locking, intermittent block to range of motion, or loose body sensation that could indicate meniscal displacement or an IA loose body
  4. injection into the index knee within 3 months prior to screening
  5. Viscosupplement (e.g., hyaluronic acid [HA]) injection, -rich plasma injection, bone marrow aspirate (BMA) or bone marrow aspiration concentrate (BMAC), placental-derived tissue/cells, adipose tissue, or any other autologous or allogeneic product into the index knee within 6 months prior to screening
  6. Patients with known reactions to ASA or any of its constituents (e.g., HA, dimethyl sulfoxide [DMSO])
  7. Knee surgery on the index knee within 12 months prior to screening and/or planned knee surgery during the study
  8. Knee surgery on the contralateral knee within 6 months prior to screening and/or planned knee surgery during the study
  9. Acute index knee trauma within 3 months prior to screening
  10. Knee effusion requiring aspiration of the index or contralateral knee within 3 months prior to screening
  11. Contralateral knee pain ≥ 4 on the WOMAC Pain scale on most days during the past week.
  12. Current therapy with any therapy, including corticosteroids (> 5 mg/day of prednisone)
  13. findings on the screening laboratory tests or physical examination that are not specific to OA of the knee and may interfere with study conduct or interpretation of data or increase patient risk
  14. Clinically significant intercurrent illness, medical condition, non-knee pain, or medical history (including neurological or mental illness, , fibromyalgia, complex regional pain syndrome, or any active infection, including or C) that could jeopardize the patient safety, limit participation, or compromise interpretation of data derived from the patient
  15. Active alcohol or substance use disorder, or any other reason that would make it unlikely for the patient to comply with study procedures
  16. Females who are pregnant (positive pregnancy test at screening or prior to treatment) or lactating
  17. Participation in another clinical trial within the 30 days (or 5 half-lives of the compound, whichever is longer) before screening
Terms in these criteria, in plain language(12)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Postmenopausal

Periods have stopped for good: usually no period for 12 months in a row without another medical reason, sometimes confirmed by a blood test (FSH).

Contraception

Ways of preventing pregnancy. “Highly effective” methods fail less than 1% of the time a year when used correctly — for example an IUD or an implant.

Criteria usually say which methods count and how long to keep using them after the last dose, sometimes for male participants too. Some studies accept a partner’s vasectomy if it was confirmed successful and that person is the participant’s only sexual partner.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Corticosteroids (steroids)

Anti-inflammatory medicines such as prednisone, prednisolone and dexamethasone — not the anabolic steroids used for muscle.

Studies differ in what they allow: check which steroid medicines, routes (tablets, injections, creams, inhalers, eye drops) and doses this study accepts.

Platelets

Blood cells that help blood clot. Too few raises the risk of bleeding and bruising. A usual adult range is about 150–400 × 10⁹/L (150,000–400,000 per µL); each lab has its own reference range.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Immunosuppression

A weakened immune system. It can come from an illness, such as HIV or some blood cancers, or from medicines that turn the immune system down, for example after an organ transplant or for an autoimmune disease; steroids at higher doses count.

Read whether the line is about a condition or about medicines, and which medicines and doses it means.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

05

Study design

Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Quadruple (Participant, Care provider, Investigator, Outcomes assessor)
Enrollment
516 participants (actual)

Study arms

  • Experimental
    ASA

    Participants receive a single IA injection of 2 mL of ASA (plus 2 mL of normal saline)

    Biological: Amniotic Suspension Allograft

  • Placebo comparator
    Placebo

    Participants receive a single IA injection of 4 mL of normal saline

    Drug: Placebo

Interventions

  • BiologicalAmniotic Suspension Allograft

    This investigational product is a cryopreserved product derived from human amnion and cells from the amniotic fluid.

  • DrugPlacebo

    Matching placebo is 0.9% normal saline: 4 mL to be injected IA.

06

What researchers measure

Primary outcomes

  1. The difference in change from baseline in WOMAC Pain scale at 6 months between ASA- and placebo-treated patients

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 26

Secondary outcomes

  1. The difference between changes from baseline for ASA- and placebo- treated patients in WOMAC Function at 6 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 26

  2. The difference between changes from baseline for ASA- and placebo-treated patients in the OMERACT-OARSI responder rate at 6 months

    Outcome Measures in Rheumatoid Arthritis Clinical Trials - Osteoarthritis Research Society International. (OMERACT-OARSI) Responders are defined as participants with high improvement in pain or function.

    Time frame: Baseline to Week 26

  3. The difference between changes from baseline for ASA- and placebo-treated patients in WOMAC Pain at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 12

  4. The difference between changes from baseline for ASA- and placebo- treated patients in non-inferiority of WOMAC Function at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 12

  5. The difference between changes from baseline for ASA- and placebo-treated patients in the OMERACT-OARSI responder rate at 3 months

    Outcome Measures in Rheumatoid Arthritis Clinical Trials - Osteoarthritis Research Society International. (OMERACT-OARSI) Responders are defined as participants with high improvement in pain or function.

    Time frame: Baseline to Week 12

  6. The difference between changes from baseline for ASA- and placebo-treated patients in the WOMAC Total at 6 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 26

  7. The difference between ASA- and placebo-treated patients in the WOMAC Stiffness at 6 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 26

  8. The difference between changes from baseline for ASA- and placebo- treated patients in the WOMAC Total at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 12

  9. The difference between changes from baseline for ASA- and placebo-treated patients in the WOMAC Stiffness at 3 months

    The Western Ontario and McMaster Universities (WOMAC®) Osteoarthritis Index is a questionnaire that measures pain, stiffness, and function both independently and collectively, using a Likert 3.1, 5-point scale. The Likert Scale uses the following descriptors for all items: none, mild moderate, severe, and extreme, corresponding to an ordinal scale of 0-4. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations.

    Time frame: Baseline to Week 12

  10. Incidence of adverse events (AEs)

    An AE is any untoward medical occurrence in a clinical study patient administered a medicinal (investigational or non-investigational) product. An AE does not necessarily have a causal relationship with the treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal finding), symptom, or disease temporally associated with the use of a medicinal (investigational or non-investigational) product, whether or not related to that medicinal (investigational or non-investigational) product. This includes any occurrence that is new in onset or aggravated in severity or frequency from the baseline condition, or abnormal result of diagnostic procedures, including clinical laboratory test abnormalities.

    Time frame: Baseline to Week 52

07

Study locations

38 sites
  • Central Research Associates
    Birmingham, Alabama 35205, United States
  • Alabama Clinical Therapeutics
    Birmingham, Alabama 35235, United States
  • AMR Mobile
    Mobile, Alabama 36608, United States
  • Arizona Arthritis & Rheumatology Research
    Glendale, Arizona 85306, United States
  • Fiel Family & Sports Medicine/ CCT Research
    Tempe, Arizona 85283, United States
  • Arizona Arthritis & Rheumatology Research
    Tucson, Arizona 85704, United States
  • Tri West Research Associates
    El Cajon, California 92020, United States
  • Horizon Clinical Research Center
    La Mesa, California 91942, United States
  • Actca, A Member of the Allliance Inc.
    Los Angeles, California 90036, United States
  • University of California at Los Angeles
    Los Angeles, California 90095, United States
  • Stanford Medicine
    Redwood City, California 94063, United States
  • University of California at Davis
    Sacramento, California 95186, United States
  • AARDS Research, Inc.
    Aventura, Florida 33180, United States
  • Gulfcoast Research Institute
    Sarasota, Florida 34232, United States
  • Pinnacle Trials, Inc.
    Stockbridge, Georgia 30281, United States
  • Injury Care Research
    Boise, Idaho 83713, United States
  • Chicago Clinical Research Institute Inc
    Chicago, Illinois 60607, United States
  • Rush University Medical Center
    Chicago, Illinois 60612, United States
  • Affinity Health
    Oak Brook, Illinois 60523, United States
  • Sinai Hospital of Baltimore
    Baltimore, Maryland 21215, United States
  • Klein & Associates, MD, PA
    Hagerstown, Maryland 21740, United States
  • Tufts Medical Center
    Boston, Massachusetts 02111, United States
  • Methodist Physicians Clinic/ CCT Researc
    Fremont, Nebraska 68025, United States
  • Physician Research Collaboration
    Lincoln, Nebraska 68516, United States
  • NYU Langone Health
    New York, New York 10016, United States
  • Hospital for Special Surgery
    New York, New York 10021, United States
  • Lenox Hill Hospital (Northwell Health)
    New York, New York 10075, United States
  • M3 Emerging Medical Research, LLC
    Durham, North Carolina 27704, United States
  • Moore Orthopedics and Sports Medicine
    Morehead City, North Carolina 28557, United States
  • M3 Emerging Medical Research, LLC
    Raleigh, North Carolina 27612, United States
  • Lehigh Center for Clinical Research
    Allentown, Pennsylvania 18104, United States
  • University Orthopedics Center
    Altoona, Pennsylvania 16602, United States
  • University Orthopedic Center
    State College, Pennsylvania 16801, United States
  • PCPMG Clinical Research Unit, LLC
    Greenville, South Carolina 29501, United States
  • Coastal Carolina Research Center
    North Charleston, South Carolina 29406, United States
  • Affinity Health
    Nashville, Tennessee 37203, United States
  • Cedar Health Research, LLC
    Burleson, Texas 76028, United States
  • Spectrum Medical, Inc
    Danville, Virginia 24541, United States
08

References and documents

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Ran from Dec 2020 to primary completion in Jul 2023, 31 months.

Of 65 industry-sponsored phase 3 interventional studies under Osteoarthritis, Knee, half reached primary completion within 20 months of starting (the median), counting those still running; a quarter within 13 and three quarters within 27. This study's 31 months is above that.

Counting every sponsor, half of 100 studies reached it within 21 months; a quarter within 15 and three quarters within 35.

How these figures are worked out, and which studies are left out of them.

Registered
Nov 5, 2020
First posted
Nov 19, 2020
StartActual
Dec 14, 2020
Primary completionActual
Jul 30, 2023
CompletionActual
Aug 19, 2025
Last update
Oct 16, 2025
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Oct 16, 2025, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04636229
Lead sponsor
Organogenesis
Collaborators
Premier Research
Responsible party
Sponsor
First posted
Nov 19, 2020
Start date
Dec 14, 2020
Primary completion
Jul 30, 2023
Completion
Aug 19, 2025
Last update
Oct 16, 2025

Oversight

Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Oct 2025. You cannot join it, but the record below documents what was studied.

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