A Phase 1/2 interventional study of Axolotl Ambient and "Drug/Placebo: 0.9% Normal Saline" in Ankle Osteoarthritis, sponsored by Axolotl Biologix. Terminated at 3 sites in United States. Open to participants aged 18 Years to 80 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-08-07.
Sponsored by Axolotl Biologix · Phase 1/2, Interventional, and Treatment
A Double-blind, Multi-Center, Prospective, Randomized Placebo-controlled Pilot Study Evaluating Intra-articular Injection of Axolotl Ambient Compared to Saline in Subjects with Ankle Osteoarthritis. The goal of this pilot study and subsequent pivotal trial is to evaluate the safety and effectiveness of Axolotl Ambient intra-articular injection for ameliorating the pain and dysfunction associated with ankle OA.
This pilot study is a double-blind multi-center, prospective, randomized, placebo-controlled trial. Upon randomization, patients will receive 1 intraarticular injection of the investigational product or control fluid. Follow-up will be conducted at 4 weeks, 3 and 6 months, with 6 months serving as the primary endpoint. The primary outcomes will consist of patient reported outcomes of pain and functional assessment by the physician, specific to the foot and ankle. Subjects will be monitored for an additional 6 months to establish safety over a 1-year follow-up and evaluate the durability of benefit.
2,974 studies on the registry are indexed under Osteoarthritis; 438 are open to participants now.
This study's enrollment of 12 is below the median of 80 across 2,240 interventional studies indexed under Osteoarthritis.
Browse Osteoarthritis studies →Axolotl Biologix is the lead sponsor of 2 studies on the registry; 1 is open to participants now.
Counted across the registry records on this site, refreshed daily.
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.
Exclusion Criteria:
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.
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.
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.
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
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).
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.
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.
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.
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.
A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.
Stroke symptoms need emergency care at once, even if they go away.
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.
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.
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.
Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Childbearing potential
Able to become pregnant: from the first period until menopause, unless permanently unable to through surgery (removal of the womb, or of both ovaries or both fallopian tubes).
Criteria for people of childbearing potential usually ask for a negative pregnancy test and for contraception during the study and for a time after it.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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).
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
TIA (transient ischaemic attack)
A “mini-stroke”: temporary stroke-like symptoms caused by reduced blood flow to part of the brain, spinal cord or eye, without signs of a new stroke on a scan.
Stroke symptoms need emergency care at once, even if they go away.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
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.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Cancer (malignancy)
Malignancy means cancer. Criteria about another or earlier malignancy ask whether you have had a different cancer, usually within a set number of years.
Some are commonly allowed, such as treated skin cancers other than melanoma and early cancers removed completely — check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Autoimmune disease
A condition in which the immune system attacks the body’s own tissues, such as rheumatoid arthritis, lupus, psoriasis, type 1 diabetes or inflammatory bowel disease.
Immunotherapy studies often leave out active autoimmune disease, and some name exceptions, such as thyroid disease on replacement hormone. Check the exceptions this study lists.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Single dose, 2.0 mL of 0.9% normal saline, administered via intra-articular injection administered to the affected tibiotalar joint.
Drug: "Drug/Placebo: 0.9% Normal Saline"
Biological/Vaccine: Axolotl Ambient Axolotl Ambient is an allogeneic amniotic intraarticular injection therapy consisting of a growth factor and cytokine-rich fluid derived from human amnion cells. Other Names: • CA20
Biological: Axolotl Ambient
Axolotl Ambient is an allogeneic amniotic intra-articular injection therapy consisting of a growth factor and cytokine-rich fluid derived from human amnion cells.
Also known as: CA20
"Drug/Placebo: 0.9% Normal Saline"
Change From Baseline in Ankle Osteoarthritis Scale (AOS; 48 hr Recall) Pain Subscale
The Ankle Osteoarthritis Scale (AOS) pain subscale goes from 0 (No pain) -100 (The worst imaginable).
Time frame: 4-weeks, 3-months, and 6-months
Change From Baseline for Ankle Osteoarthritis Scale (AOS; 48 hr Recall) Function Subscale
The Ankle Osteoarthritis Scale (AOS) functions subscale goes from 0 (No difficulty) -100 (So difficult, unable).
Time frame: 4-week, 3 Months, 6-months
Change From Baseline for Foot and Ankle Outcome Score (FAOS) for Pain Subscale
A score of 100 represents no pain. A score of 0 constant pain.
Time frame: 4-weeks, 3-months, 6-months
Change From Baseline for Foot and Ankle Outcome Score (FAOS) for Function Subscale
100 represents perfect health and 0 represents extreme problems and complete functional limitation. .
Time frame: 4-weeks, 3-months, 6-months
Proportion of Patients Achieving Composite Clinical Success (CCS).
CCS defined as a patient meeting all of the three following criteria: 1. Improvement in AOS (Pain and Function) or FAOS scores (Pain and ADL) of at least 20% from baseline 2. No surgical intervention or prescription pain medications for ankle OA 3. No treatment or procedure-related serious adverse events
Time frame: 4-weeks, 3-months, 6-months
Incidence of Adverse Events
Proportion of subjects experiencing at least (1) adverse events.
Time frame: Post-procedure follow-up assessments: 4 weeks (+/-7days), 3 Months (+/- 14 days), 6 Months (+/- 30 days), 12 Months (+/- 60 days), and unscheduled visits (up to 19 months)
FAOS Subscales Quality of Life (QoL)
0 (most severe problems) to 100 (no problems/best possible qualify of life)
Time frame: 4-week, 3-month, 6-month
Visual Analog Scale (VAS) for Ankle Pain (Average During Last 48 Hours)
100 millimeter scale 0mm - No Pain and 100mm - Worst Imaginable Pain
Time frame: 4 weeks, 3-months, 6-months
VAS Ankle Pain (Worst During Last 48 Hours)
100 millimeter scale 0mm - No Pain and 100mm - Worst Imaginable Pain
Time frame: 4-weeks, 3-months, 6-months
EuroQOL-5 Dimension-5 Level (EQ-5D-5L) Quality of Life Scale
0 to 100 scale - 0 the worst health you can imagine to 100 the best health you can imagine.
Time frame: 4-weeks, 3-months, 6-months
Working Status
Not working, unrelated to ankle Not working, related to ankle Working with major limitations related to ankle Working without limitations related to ankle
Time frame: Baseline, 4-weeks, 3-months, 6-months
K-L Grade From Weightbearing X-ray at Baseline and 6 Months
Grade 2 Definite osteophytes with mild to moderate joint space narrowing; early radiographic OA Grade 3a Significant osteophytes and joint space narrowing, but greater than 50% of the joint space remains preserved Grade 3b Severe joint space narrowing with less than 50% remaining joint space, approaching end-stage disease but not completely bone-on-bone Grade 4 Near complete or complete loss of joint space with substantial deformity (end-stage OA)
Time frame: Baseline, 6-months
| Milestone | Control Group | Investigational Group |
|---|---|---|
| Started | 6 | 6 |
| Completed | 2 | 2 |
| Not completed | 4 | 4 |
The Ankle Osteoarthritis Scale (AOS) pain subscale goes from 0 (No pain) -100 (The worst imaginable).
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | -7.0 ± 24.08 | -2.2 ± 23.32 |
| 3-months | -11.7 ± 31.97 | 19.3 ± 32.75 |
| 6-months | -4.5 ± 12.47 | 6.3 ± 16.26 |
The Ankle Osteoarthritis Scale (AOS) functions subscale goes from 0 (No difficulty) -100 (So difficult, unable).
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | -13.3 ± 23.55 | -0.6 ± 23.51 |
| 3-months | -14.2 ± 19.05 | 12.3 ± 24.03 |
| 6-months | -7.3 ± 7.74 | 8.7 ± 21.08 |
A score of 100 represents no pain. A score of 0 constant pain.
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | 10.0 ± 15.97 | 5.8 ± 22.33 |
| 3-months | 16.5 ± 14.60 | -13.0 ± 20.42 |
| 6-months | 8.8 ± 7.79 | -6.3 ± 12.66 |
100 represents perfect health and 0 represents extreme problems and complete functional limitation. .
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | 5.0 ± 8.69 | 2.8 ± 11.82 |
| 3-months | 8.5 ± 7.92 | -6.7 ± 10.97 |
| 6-months | 4.7 ± 2.50 | -3.3 ± 7.37 |
CCS defined as a patient meeting all of the three following criteria: 1. Improvement in AOS (Pain and Function) or FAOS scores (Pain and ADL) of at least 20% from baseline 2. No surgical intervention or prescription pain medications for ankle OA 3. No treatment or procedure-related serious adverse events
| Participants | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | 3 | 1 |
| 3-months | 3 | 1 |
| 6-months | 2 | 0 |
Proportion of subjects experiencing at least (1) adverse events.
| Participants | Control Group | Investigational Group |
|---|---|---|
| Incidence of Adverse Events | 5 | 2 |
0 (most severe problems) to 100 (no problems/best possible qualify of life)
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | 12.5 ± 17.27 | 11.4 ± 38.62 |
| 3-months | 14.5 ± 20.39 | 0.0 ± 13.00 |
| 6-months | 9.0 ± 18.60 | 2.0 ± 3.46 |
100 millimeter scale 0mm - No Pain and 100mm - Worst Imaginable Pain
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | 3.0 ± 43.69 | -0.6 ± 33.47 |
| 3-months | -12.2 ± 40.91 | 26.0 ± 29.00 |
| 6-months | -15.3 ± 14.29 | 8.7 ± 15.82 |
100 millimeter scale 0mm - No Pain and 100mm - Worst Imaginable Pain
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | -4.2 ± 32.85 | 2.2 ± 38.80 |
| 3-months | -11.2 ± 39.21 | 35.3 ± 35.92 |
| 6-months | -13.7 ± 16.77 | 5.0 ± 10.00 |
0 to 100 scale - 0 the worst health you can imagine to 100 the best health you can imagine.
| score on a scale | Control Group | Investigational Group |
|---|---|---|
| 4-weeks | 8.3 ± 13.94 | -0.4 ± 21.87 |
| 3-months | -0.2 ± 20.74 | -20.0 ± 21.79 |
| 6-months | -5.7 ± 29.14 | -6.7 ± 7.64 |
Not working, unrelated to ankle Not working, related to ankle Working with major limitations related to ankle Working without limitations related to ankle
| Participants | Control Group | Investigational Group |
|---|---|---|
| Baseline — Not working, unrelated to ankle | 2 | 1 |
| Baseline — Not working, related to ankle | 1 | 0 |
| Baseline — Working with major limitations related to ankle | 0 | 1 |
| Baseline — Working without limitations related to ankle | 3 | 4 |
| 4-weeks — Not working, unrelated to ankle | 1 | 1 |
| 4-weeks — Not working, related to ankle | 0 | 0 |
| 4-weeks — Working with major limitations related to ankle | 2 | 0 |
| 4-weeks — Working without limitations related to ankle | 3 | 4 |
| 3months — Not working, unrelated to ankle | 1 | 0 |
| 3months — Not working, related to ankle | 0 | 0 |
| 3months — Working with major limitations related to ankle | 2 | 1 |
| 3months — Working without limitations related to ankle | 3 | 2 |
| 6months — Not working, unrelated to ankle | 2 | 0 |
| 6months — Not working, related to ankle | 0 | 0 |
| 6months — Working with major limitations related to ankle | 2 | 1 |
| 6months — Working without limitations related to ankle | 2 | 2 |
Grade 2 Definite osteophytes with mild to moderate joint space narrowing; early radiographic OA Grade 3a Significant osteophytes and joint space narrowing, but greater than 50% of the joint space remains preserved Grade 3b Severe joint space narrowing with less than 50% remaining joint space, approaching end-stage disease but not completely bone-on-bone Grade 4 Near complete or complete loss of joint space with substantial deformity (end-stage OA)
| Participants | Control Group | Investigational Group |
|---|---|---|
| baseline Day 0 — Grade 2 Definite osteophytes with mild to moderate joint space narrowing; early radiographic OA | 4 | 2 |
| baseline Day 0 — Grade 3a | 1 | 3 |
| baseline Day 0 — Grade 3b | 1 | 0 |
| baseline Day 0 — Grade 4 | 0 | 0 |
| 6 Month — Grade 2 Definite osteophytes with mild to moderate joint space narrowing; early radiographic OA | 3 | 0 |
| 6 Month — Grade 3a | 1 | 1 |
| 6 Month — Grade 3b | 0 | 0 |
| 6 Month — Grade 4 | 0 | 0 |
Collected over 19 months. Non-serious events are listed at a 0% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Control Group | 0/6 (0%) | 0/6 (0%) | 5/6 (83.3%) |
| Investigational Group | 0/6 (0%) | 0/6 (0%) | 2/6 (33.3%) |
| Event | Control Group | Investigational Group |
|---|---|---|
| Back PainMusculoskeletal and connective tissue disorders | 3/6 | 0/6 |
| Foot and Ankle PainMusculoskeletal and connective tissue disorders | 3/6 | 0/6 |
| Hip PainMusculoskeletal and connective tissue disorders | 2/6 | 0/6 |
| Back InjuryMusculoskeletal and connective tissue disorders | 0/6 | 1/6 |
| Left Hip OsteoarthritisMusculoskeletal and connective tissue disorders | 0/6 | 1/6 |
| Muscle SpasmsMusculoskeletal and connective tissue disorders | 1/6 | 0/6 |
| Knee PainMusculoskeletal and connective tissue disorders | 1/6 | 0/6 |
| Foot NumbnessMusculoskeletal and connective tissue disorders | 1/6 | 0/6 |
| Wrist PainMusculoskeletal and connective tissue disorders | 1/6 | 0/6 |
| BronchitisRespiratory, thoracic and mediastinal disorders | 1/6 | 0/6 |
| Age, Categorical(Participants) | Control Group | Investigational Group | Total |
|---|---|---|---|
| <=18 years | 0 | 0 | 0 |
| Between 18 and 65 years | 6 | 6 | 12 |
| >=65 years | 0 | 0 | 0 |
| Sex/Gender, Customized(Participants) | Control Group | Investigational Group | Total |
|---|---|---|---|
| Male or Female | 6 | 6 | 12 |
| Race and Ethnicity Not Collected(Participants) | Control Group | Investigational Group | Total |
|---|---|---|---|
| Count of participants | — | — | 0 |
| Region of Enrollment(participants) | Control Group | Investigational Group | Total |
|---|---|---|---|
| United States | 6 | 6 | 12 |
PDFs hosted by the registry, ClinicalTrials.gov.
Plan to share: No
Ran from Dec 2021 to primary completion in Nov 2023, 23 months.
Results were first posted in Aug 2026, 2 years 8 months after primary completion.
How these figures are worked out, and which studies are left out of them.
This study is terminated, as verified in Aug 2026. You cannot join it, but the record below documents what was studied.
Get an email when the registry record changes — status, dates, results — or when someone posts here.
Sign in to followQuestions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.
Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.
Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.
Axolotl Biologix