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Cingal

Phase 3

Knee Osteoarthritis | Small molecule | Musculoskeletal |Anika Therapeutics Inc.|Last Updated: Aug 9, 2023

Success Probability

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Trial Design

RandomizedDouble-BlindACTIVE_CONTROLLEDDMC
Total Trials2
Total Enrollment1,102

FDA Designations

No designations recorded

Clinical trial landscape

Cingal · 4 trials · 3 indications

Phase 3 4
NCT04231318Study of Cingal® and Triamcinolone Hexacetonide for the Relief of Knee Osteoarthritis PainOsteoarthritis, Knee
COMPLETED231 Analytics
NCT03390036Study of Cingal for the Relief of Knee Osteoarthritis Compared to Triamcinolone Hexacetonide at 39 Weeks Follow upKnee Osteoarthritis
COMPLETED526 Analytics
NCT03191903Study of Cingal™ for the Relief of Knee Osteoarthritis Compared to Triamcinolone HexacetonideKnee Osteoarthritis
COMPLETED576 Analytics
NCT02381652Repeat Injection of Cingal® for Osteoarthritis of the KneeOsteoarthritis of the Knee
COMPLETED242 Analytics
PHASE3COMPLETED
Study of Cingal® and Triamcinolone Hexacetonide for the Relief of Knee Osteoarthritis Pain
Osteoarthritis, KneeUnlock trial analytics
PHASE3COMPLETED
Study of Cingal for the Relief of Knee Osteoarthritis Compared to Triamcinolone Hexacetonide at 39 Weeks Follow up
Knee OsteoarthritisUnlock trial analytics
PHASE3COMPLETED
Study of Cingal™ for the Relief of Knee Osteoarthritis Compared to Triamcinolone Hexacetonide
Knee OsteoarthritisUnlock trial analytics
PHASE3COMPLETED
Repeat Injection of Cingal® for Osteoarthritis of the Knee
Osteoarthritis of the KneeUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in the Western Ontario and McMaster Universities Arthritis Index (WOMAC) Pain Score
26 Weeks

The change from Baseline in knee pain post-treatment as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Score comparing the Cingal arm to the TH arm, the Cingal arm to the Placebo arm, and the TH arm to the Placebo arm. WOMAC Pain is a validated 100 mm visual analog scale (VAS) from 0 mm = No Pain to 100 mm = Highest Pain Level. A negative value for the change from Baseline indicates improvement in the WOMAC Pain Score, i.e. less pain post-treatment. A larger negative value indicates lower pain levels and a better outcome.

OMERACT-OARSI Responder Rate at 39 Weeks
39 weeks

The post treatment Responder Rate at 39 weeks is determined through a calculation defined by the Outcomes Measures for Rheumatic Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) Responder Index. The OMERACT-OARSI Responder Index reports the percentage of subjects that met the criteria to be a good responder. The criteria for response are (1) improvement in pain or physical function ≥50% and an absolute change ≥20 mm; or (2) improvement of ≥20% with an absolute change ≥10 mm in at least two of the following three categories: pain, physical function, and patient's global assessment. A higher percentage of subjects responding indicates a better outcome.

Change From Baseline in WOMAC Pain Score at 26 Weeks (ITT Population)
26 weeks

The change from baseline in knee pain as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Score comparing the Cingal group to the TH group. The WOMAC Pain Score is a validated visual analog scale from 0 mm = no pain to 100 mm = highest pain level. A negative number for the change from baseline indicates reduction in pain. A greater negative difference from baseline means a better outcome.

Number of Treatment-Emergent Adverse Events: Cingal 13-02 vs. Cingal 13-01
Baseline through 6 weeks post-injection

The primary outcome measure will compare safety results (all adverse events, whether related to the study injection or not) for Cingal 13-01 and Cingal 13-02.

Secondary Endpoints

The Outcomes Measures for Rheumatic Arthritis Clinical Trials-Osteoarthritis Research Society International (OMERACT-OARSI) Responder Index
26 Weeks
Change From Baseline in Knee Pain as Measured by Visual Analog Scale (VAS) Pain Score
26 Weeks
Change From Baseline in Knee Pain as Measured by Numerical Rating Scale (NRS) Pain Score
26 Weeks
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Study Design & Arms

AllocationRANDOMIZED
MaskingDOUBLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
CingalEXPERIMENTALSingle injection of Cingal: 4 milliliter (mL) dose of 88 mg (22 mg/mL) of cross-linked sodium hyaluronate with 18 mg (4.5 mg/mL) of triamcinolone hexacetonide (TH). Manufactured by Anika Therapeutics.
Triamcinolone Hexacetonide (TH)ACTIVE_COMPARATORSingle injection of Triamcinolone Hexacetonide (TH): 1 milliliter (mL) dose of 20 mg/ml TH. Manufactured by IntraPharm.
PlaceboPLACEBO_COMPARATORSingle injection of Placebo: 4 milliliter (mL) dose of 0.9% saline. Manufactured by Anika Therapeutics.
MonoviscACTIVE_COMPARATORMonovisc is a device that consists of 88 milligrams of cross-linked HA (hyaluronic acid) in a 4 milliliter (mL) intra-articular injection.
Cingal/CingalEXPERIMENTALSubjects who had received an injection of Cingal in the 13-01 study will receive a single 4 milliliter (mL) intra-articular injection of Cingal (88 milligrams Hyaluronic Acid plus 18 milligramsTriamcinolone Hexacetonide) in the index knee in the 13-02 study.
Cingal/MonoviscEXPERIMENTALSubjects who had received an injection of Monovisc in the 13-01 study will receive a single 4 milliliter (mL) intra-articular injection of Cingal (88 milligrams Hyaluronic Acid plus 18 milligramsTriamcinolone Hexacetonide) in the index knee in the 13-02 study.
Cingal/SalineEXPERIMENTALSubjects who had received an injection of Saline in the 13-01 study will receive a single 4 milliliter (mL) intra-articular injection of Cingal (88 milligrams Hyaluronic Acid plus 18 milligramsTriamcinolone Hexacetonide) in the index knee in the 13-02 study.

Interventions

NameTypeDescription
CingalDRUGSingle intra-articular injection of Cingal into the knee.
Triamcinolone Hexacetonide (TH)DRUGSingle intra-articular injection of TH into the knee.
PlaceboDRUGSingle intra-articular injection Placebo (0.9% Saline) into the knee.
MonoviscDEVICEHyaluronic Acid
Triamcinolone HexacetonideDRUGTriamcinolone Hexacetonide
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Eligibility Criteria

Age Range40 Years to 75 Years
SexALL
Healthy VolunteersNo
Study Sites26

Inclusion Criteria: 1. Subject is 40-75 years old. 2. Body Mass Index (BMI) ≤ 40 kg/m2. 3. Subject has Kellgren-Lawrence (K-L) severity grade II or III in the Index knee as determined by X-Ray. Contralateral knee: K-L severity grade 0, I or II. 4. Subject has had at least two signs and at least two...

Countries:United StatesHungaryPolandCzechia
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Frequently asked questions about Cingal

What is Cingal used for?

Cingal is an investigational small molecule being developed for knee osteoarthritis, including osteoarthritis of the knee. It is intended to provide relief for patients with this condition. The drug is currently in Phase 3 clinical development and has not been approved by regulatory authorities.

Who makes Cingal?

Cingal is being developed by Anika Therapeutics Inc., a company traded on the NASDAQ under the ticker symbol ANIK. The company is conducting Phase 3 clinical trials to evaluate the drug's safety and efficacy for knee osteoarthritis.

What phase is Cingal in?

Cingal is in Phase 3 clinical development. It is an investigational drug and has not been approved by the FDA or other regulatory agencies. Multiple Phase 3 trials have been completed to assess its use for knee osteoarthritis.

What clinical trials is Cingal in?

Cingal has been studied in several Phase 3 clinical trials, including NCT02381652, NCT03191903, NCT03390036, and NCT04231318. These trials evaluated repeat injections and comparisons to triamcinolone hexacetonide for knee osteoarthritis relief. All trials are completed.

How does Cingal work?

Cingal is a small molecule designed to treat knee osteoarthritis. Its specific molecular target has not been disclosed in available information, so its exact mechanism of action is not detailed here.