## Protocol Section
### Identification Module
**NCT ID:** NCT03561779

**Brief Title:** Clinical Trial of YYD302 (Phase3) for Treatment of Osteoarthritis of the Knee

**Official Title:** A Randomized, Double-blind, Active-controlled, Multi-center, Phase 3 Study to Evaluated the Safety and Efficacy of Intraarticular Hyalurinic Acid(YYD302) for Osteoarthritis of the Knee After 12 Weeks of Treatment and Retreatment

#### Organization Study ID Info
**ID:** YY_YYD302_003
#### Organization
**Class:** INDUSTRY
**Full Name:** Yooyoung Pharmaceutical Co., Ltd.
### Status Module
#### Completion Date
**Date:** 2019-10-04

**Type:** ACTUAL

#### Expanded Access Info
#### Last Update Post Date
**Date:** 2021-05-10

**Type:** ACTUAL

**Last Update Submit Date:** 2021-05-07

**Overall Status:** COMPLETED

#### Primary Completion Date
**Date:** 2019-06-14

**Type:** ACTUAL

#### Start Date
**Date:** 2018-02-21

**Type:** ACTUAL

**Status Verified Date:** 2021-05

#### Study First Post Date
**Date:** 2018-06-19
**Type:** ACTUAL
**Study First Submit Date:** 2018-06-04
**Study First Submit QC Date:** 2018-06-17
### Sponsor Collaborators Module

#### Lead Sponsor

**Class:** INDUSTRY

**Name:** Yooyoung Pharmaceutical Co., Ltd.

#### Responsible Party

**Type:** SPONSOR

### Oversight Module

**Is FDA Regulated Device:** False

**Is FDA Regulated Drug:** False

**Oversight Has DMC:** True

### Description Module

**Brief Summary:** This is a randomized, double-blind, active-controlled, multi-center, phase 3 study to evaluate the safety and efficacy of intraarticular hyaluronic acid(YYD302) for osteoarthritis of the knee after 12 weeks of treatment and retreatment

**Detailed Description:** First Injection: A multicenter, active-controlled, randomized, evaluator and subject bllinded, parallel, phase 3 study Re-Injection: A multicenter, active-controlled, randomized, parallel

### Conditions Module

**Conditions:**

- Osteoarthritis, Knee

**Keywords:**

- Osteoarthritis

### Design Module

#### Design Info

**Allocation:** RANDOMIZED

**Intervention Model:** PARALLEL

**Intervention Model Description:** The Subjects are injected investigational Product (YYD302 or Synovian Inj.)

##### Masking Info

**Masking:** DOUBLE

**Who Masked:**

- PARTICIPANT

- INVESTIGATOR

**Primary Purpose:** TREATMENT

#### Enrollment Info

**Count:** 184

**Type:** ACTUAL

**Phases:**

- PHASE3

**Study Type:** INTERVENTIONAL

### Arms Interventions Module

#### Arm Group 1

**Description:** YYD302 (2ml)

**Intervention Names:**

- Drug: YYD302 2ml

**Label:** YYD302

**Type:** EXPERIMENTAL

#### Arm Group 2

**Description:** Synovian Inj. (3ml)

**Intervention Names:**

- Drug: Active comparator: Synovian Inj.

**Label:** Synovian Inj.

**Type:** ACTIVE_COMPARATOR

### Interventions

#### Intervention 1

**Arm Group Labels:**

- YYD302

**Description:** YYD302 2ml

**Name:** YYD302 2ml

**Type:** DRUG

#### Intervention 2

**Arm Group Labels:**

- Synovian Inj.

**Description:** Active comparator: Synovian Inj.

**Name:** Active comparator: Synovian Inj.

**Other Names:**

- Synovian Inj.

**Type:** DRUG

### Outcomes Module

#### Primary Outcomes

**Description:** Weight-bearing pain(100mm-VAS) assessed by the subject

**Measure:** Rate of change of the Weight-bearing pain(100mm-VAS) on 12 weeks after first injection in comparison with baseline

**Time Frame:** Change of the week 12 from baseline

#### Secondary Outcomes

**Description:** Weight-bearing pain(100mm-VAS) assessed by the subject

**Measure:** Rate of change of the Weight-bearing pain(100mm-VAS) on 2, 4 weeks after administration in comparison with baseline

**Time Frame:** Change of the week 2, 4 from baseline

**Description:** KOOS scales assessed by the subject

**Measure:** Rate of change of the KOOS scales on the 2, 4, 12 weeks after administration in comparison with baseline

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Rest pain(100mm-VAS) assessed by the subject

**Measure:** Rate of change of the rest pain(100mm-VAS) on the 2, 4, 12 weeks after administration in comparison with baseline

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Motion pain(100mm-VAS) assessed by the subject

**Measure:** Rate of change of the Motion pain (100mm-VAS) on the 2, 4, 12 weeks after administration in comparison with baseline

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Patient global assessment (100mm-VAS) assessed by the subject

**Measure:** Patient global assessment (100mm-VAS) on the 2, 4, 12 weeks after administration with baseline

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Patient global assessment (100mm-VAS) assessed by the investigator

**Measure:** Investigator global assessment (100mm-VAS) on the 2, 4, 12 weeks after administration with baseline

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Sweeling assessed by the investigator

**Measure:** Change of the swelling in the knee joint from baseline to 2, 4, 12 weeks after administration

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Tenderness on pressure assessed by the investigator

**Measure:** Change of the tenderness on pressure in the knee joint from baseline to 2, 4, 12 weeks after administration

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Range of motion assessed by the investigator

**Measure:** Variation of the Range Of Motion(ROM) in the knee joint on 2, 4, 12 weeks after administration with baseline

**Time Frame:** Change of the week 2, 4, 12 from baseline

**Description:** Responder rate of the Weight-bearing pain assessed by the investigator

**Measure:** Responder rate of the Weight-bearing pain on 12 weeks in comparison with baseline

**Time Frame:** Change of the week 12 from baseline

**Description:** Responder rate of the OMERACT-OARSI assessed by the investigator

**Measure:** Responder rate of the OMERACT-OARSI on 12 weeks in comparison with baseline

**Time Frame:** Change of the week 12 from baseline

**Description:** Use of rescue medication count and the total amount assessed by subject

**Measure:** Use of rescue medication count and the total amount on each visit after injection

**Time Frame:** Change of the each visit(2, 4, 12, 24, 36 weeks) after injection

**Description:** Each outcome assessed by the investigator or subject

**Measure:** The efficacy of secondary outcome 1~11 after 12 weeks(36weeks) compared with the Re-injection(24weeks) in re-injection subjects

**Time Frame:** Change of the week 12 (36 weeks) after Re-injection(24weeks)

**Description:** Each outcome assessed by the investigator or subject

**Measure:** The efficacy of secondary outcome 1~11 after baseline compared with 2, 4, 12, 24, 36 weeks in Re-injection subjects

**Time Frame:** Change of the week 2, 4, 12, 24, 36 from baseline

### Eligibility Module

**Eligibility Criteria:** Inclusion Criteria:

\[Visit 1, 2 Inclusion Criteria\]

1. Males or Females 40 years and older
2. According to the clinical diagnosis standard of the American College of Rheumatology (ACR), someone, diagnosed as a single/both sides of osteoarthritis, who corresponds to over 3 conditions of followings.

1) Over 50 years of age 2) Less than 30 minutes of morning stiffness 3) Crepitus on active motion 4) 4 bony tenderness 5) Bony enlargement 6) Nopalpable warmth of synvium 3. Within 6 months from screening visit, someone who diagnosed with Kellgren \& Lawrence Grade I\~III by the radioactive examination.

4. By the Weight-bearing pain(100mm-VAS) examination, someone who has a outcome of the single or both sides of the osteoarthritis is over 40mm 5. Patient (No-responder) who has experienced steady pain in spite of dosing NSAIDs or other pain-killers in the past.

6. Patient who can walk by themselves without helper like cane or walker etc. (If the patient who has used helper routinely from previous 6 months, evaluating the patient including the helper is possible. In this case, patient needs to use same helper continuously by end of the clinical trial test.) 7. Patient who agrees to participate in this clinical trial by themselves.

\[Visit 6, 7 Inclusion criteria\] 1. According to the clinical diagnosis standard of the American College of Rheumatology (ACR), someone, diagnosed as a single/both sides of osteoarthritis, who corresponds to over 3 conditions of followings.

1. Over 50 years of age
2. Less than 30 minutes of morning stiffness
3. Crepitus on active motion
4. 4 bony tenderness
5. Bony enlargement
6. Nopalpable warmth of synvium 2. At Re-screening visit, someone who diagnosed with Kellgren \& Lawrence Grade I\~III by the radioactive examination.

3. Patient who can walk by themselves without helper like cane or walker etc. (If the patient who has used helper routinely from previous 6 months, evaluating the patient including the helper is possible. In this case, patient needs to use same helper continuously by end of the clinical trial test.) 4. Patient who are confirmed for Responder by efficacy at visit 5.

Exclusion Criteria:

1. Someone who has BMI≥32kg/m² at the screening visit.
2. Patient who has an experience dosing psychoactive drug, narcotic analgesic which can have an effect on pain sense over 3 months habitually.
3. Patient who has been administrated gastrointestinal drug(for example H₂-blockers, misoprostol or proton pump inhibitors) regularly, who can't stop injecting for clinical study period.
4. Patient has attended abnormal values from screening test(2 times excess at upper limit of the normal values at ALT, AST, BUN, Serum Creatinine).
5. Patient who has rheumarthritis or other inflammatory metabolic arthritis.
6. Patients having serious gastrointestinal, liver, renal, heart disease.
7. When the inflammatory disease is occurred on joint area to patient like septic arthritis.
8. Patients having skin ailment at the injecting site of the joint region.
9. Patients having secondary osteoarthritis according to the Ochronosis, Hemochromatosis or systemic disease.
10. Patients who have severe pain like Sudek's atrophy, Paget's disease, Spinal disc herniation.
11. Poly-articular patients who have suffered seriously by osteoarthritis at other parts affect judge of the knee joint pain.
12. Patients who diagnosed clear interval disappearance at the knee joint by X-ray.
13. Patients who were administrated below drugs before baseline visit. 1) Patients who were injected HA at the target knee joint or other parts of knee joint in recent 9 months.

2) Patients who were injected steroids into the intra-articular knee joint in recent 3 months 3) Patients who were administrated steroids systemically by the oral medication (But, except inhalation) 4) Patients who were administerated Osteoarthritis nutrition such as glucosamine/chondroichin sulfate or physical therapy or herbal remedy(acupuncture, yellowish swelling, moxa cautery) for the purpose of pain relief in recent 2 weeks 5) Patients who have administerated steroid/No-steriod NSAIDs or other pain relief drugs (patch or other external medicine) in recents 2 weeks except Acetaminophen or below 300mg/day of Asprin 14. Patients who have joint effusion trouble were judged as a positive by tests like Patella tap test.

15. Patients who have target knee joint gotten surgical operation history including Arthroscopy within past one year (In case of having other side of knee joint or hip joint gotten surgical operation history, excepting the patients if there is possibility which can influence the target knee joint's appraisal.

16. Patients who have an operation history about target knee joint. 17. Patients who do the height weight aerobic exercise or anaerobic exercise. 18. Patients who need to be administrated anticoagulant agent together(But, except 300mg daily dose aspirin) 19. Patients who have hypersensitivity history about Investigational Product.

20. In the midst of women in their childbearing years, patients who disagree to do \* contraception by medically permitted method for 12 weeks from administrating investigational product.

* The contraception by medically permitted method: Condom, In case of using injection or insertion, In case of installing a intrauterine contraception device etc.

  21. Pregnant and lactating women 22. Patients who were injected other investigational product over a time within 30 days before participated in this clinical trail.

  23. Besides that, the patients who have difficulty to be participated in this clinical trial continuously by Principle Investigator (PI)'s decision.
* Exclusion criteria for Re-injection is except for 13-1) Re-injection date is followed by visit 7.

**Minimum Age:** 40 Years

**Sex:** ALL

**Standard Ages:**

- ADULT

- OLDER_ADULT

### Contacts Locations Module

#### Locations

**Location 1:**

**City:** Seoul

**Country:** Korea, Republic of

**Facility:** Samsung Medical Center

#### Overall Officials

**Official 1:**

**Affiliation:** Samsung Medical Center, Department of Internal Medicine

**Name:** Chul-Won Ha, M.D

**Role:** PRINCIPAL_INVESTIGATOR

### IPD Sharing Statement Module

**IPD Sharing:** UNDECIDED

### References Module

#### References

**Citation:** Park YG, Ha CW, Yoo JH, Lee WS, Lee HJ, In Y, Bae KC, Shon OJ, Kim YM, Seon JK, Song SJ, Chang CB, Kim JM, Kim CW, Kim DH, Bae JH. Intra-Articular Injection of a Novel DVS Cross-Linked Hyaluronic Acid Manufactured by Biological Fermentation (YYD302) in Patients With Knee Osteoarthritis: A Double-Blind, Randomized, Multicenter, Noninferiority Study. Clin Ther. 2021 Nov;43(11):1843-1860. doi: 10.1016/j.clinthera.2021.09.005. Epub 2021 Nov 1.

**PMID:** 34736768

## Derived Section

### Condition Browse Module - Ancestors

- ID: D000001168

- Term: Arthritis

- ID: D000007592

- Term: Joint Diseases

- ID: D000009140

- Term: Musculoskeletal Diseases

- ID: D000012216

- Term: Rheumatic Diseases

### Condition Browse Module - Browse Branches

- Abbrev: BC05

- Name: Musculoskeletal Diseases

- Abbrev: All

- Name: All Conditions

- Abbrev: BC17

- Name: Skin and Connective Tissue Diseases

### Condition Browse Module - Browse Leaves

- ID: M12926

- Name: Osteoarthritis

- Relevance: HIGH

- As Found: Osteoarthritis

- ID: M22168

- Name: Osteoarthritis, Knee

- Relevance: HIGH

- As Found: Osteoarthritis, Knee

- ID: M4476

- Name: Arthritis

- Relevance: LOW

- As Found: Unknown

- ID: M10621

- Name: Joint Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M12097

- Name: Musculoskeletal Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M15045

- Name: Rheumatic Diseases

- Relevance: LOW

- As Found: Unknown

- ID: M6323

- Name: Collagen Diseases

- Relevance: LOW

- As Found: Unknown

### Condition Browse Module - Meshes

- ID: D000010003

- Term: Osteoarthritis

- ID: D000020370

- Term: Osteoarthritis, Knee

### Misc Info Module

- Version Holder: 2024-05-24
