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ZILRETTA

Phase 3FDA approved 2017

Glenohumeral Osteoarthritis | Small molecule | Musculoskeletal |Pacira BioSciences, Inc.|Trials Updated: May 29, 2026

ZILRETTA development status

FDA approval Oct 6, 2017
Approval holderPacira Pharms Inc
ApplicationNDA208845
Highest phase Phase 3
Registered trials 7 across 2 sponsors since Dec 2011

Label indication ZILRETTA (triamcinolone acetonide extended-release injectable suspension) is indicated as an intra-articular injection for the management of osteoarthritis pain of the knee. ZILRETTA is an extended-release synthetic corticosteroid indicated as an intra-articular injection for the management of osteoarthritis pain of the knee. FDA label

ZILRETTA target and mechanism

Molecular targetglucocorticoid receptor
ModalitySmall molecule

Also known as FX006

Success Probability

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Market & Valuation

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Trial Design

RandomizedPLACEBO_CONTROLLED
Total Trials14
Total Enrollment1,817

FDA Designations

No designations recorded

ZILRETTA clinical trials

ZILRETTA · 14 trials · 9 indications

Phase 3 4Phase 2 10
NCT06269705ZILRETTA in Subjects With Shoulder OsteoarthritisGlenohumeral Osteoarthritis
ACTIVE NOT_RECRUITING150 Analytics
NCT03529942Study to Evaluate the Effect of FX006 on Synovial Inflammation in Patients With OA of the KneeOsteoarthritis, Knee
COMPLETED129 Analytics
NCT03046446Study to Assess the Safety of Repeat Administration of FX006 Administered to Patients With Osteoarthritis of the KneeOsteoarthritis of the Knee
COMPLETED208 Analytics
NCT02357459Study of FX006 for the Treatment of Pain in Patients With Osteoarthritis of the KneeOsteoarthritis of the Knee
COMPLETED486 Analytics
PHASE3ACTIVE NOT_RECRUITING
ZILRETTA in Subjects With Shoulder Osteoarthritis
Glenohumeral OsteoarthritisUnlock trial analytics
PHASE3COMPLETED
Study to Evaluate the Effect of FX006 on Synovial Inflammation in Patients With OA of the Knee
Osteoarthritis, KneeUnlock trial analytics
PHASE3COMPLETED
Study to Assess the Safety of Repeat Administration of FX006 Administered to Patients With Osteoarthritis of the Knee
Osteoarthritis of the KneeUnlock trial analytics
PHASE3COMPLETED
Study of FX006 for the Treatment of Pain in Patients With Osteoarthritis of the Knee
Osteoarthritis of the KneeUnlock trial analytics

Study Endpoints

Primary Endpoints

Change from Baseline on the Worst Daily Pain (24-hr) mean score (0-10 Numeric Rating Scale (NRS); 0 = no pain, 10 = worst possible pain) at Week 12 for ZILRETTA relative to placebo
Week 12
Mean Standardized Change in Synovial Volume (SV) at 6 Weeks
Baseline to Week 6

Synovial volume (mm\^3) as measured by MRI and read by a central imaging vendor. Standardization was performed by dividing the model-derived least squares means and corresponding confidence intervals by the adjusted standard deviation (SD). Therefore, the mean standardized change represents the change in synovial volume expressed in standard deviation units.

Total Number of Treatment Emergent Adverse Events (TEAEs) in Patients With Symptomatic Osteoarthritis (OA) of the Knee Who Received Two Doses of 32 mg FX006
Up to 52 Weeks

Analyses of adverse events (AE) were performed for events considered treatment-emergent (TE) in patients who received two doses of 32 mg FX006. TE was defined as any AE with onset after administration of the 1st dose of study drug or any event present at baseline but worsened in intensity through the study. Severity was graded by the PI using the Common Terminology Criteria for AEs Version 4.0. Grading went from Grade 1 (Mild) to Grade 5 (Death Related to AE).

Change From Baseline to Week 12 in the Weekly Mean of the Average Daily (24-hr) Pain (ADP) Intensity Scores for 32 mg FX006 Versus Placebo
Baseline and 12 Weeks

The pain intensity score is measured using an 11-point numeric rating scale (NRS), where ) indicates "no pain" and 10 indicates "pain as bad as you can imagine."

Change in Pain From Baseline as Assessed by the Numeric Pain Rating Scale (NPRS) Score
Baseline,week 12

Numeric Pain Rating Scale total score ranges from 0 (no pain) to 10 (most intense pain imaginable).

Number of Patients With Successful Study Drug Administrations
Day 1

Successful study drug administration, defined as Injector reporting complete study drug administration.

Concentration of Triamcinolone Acetonide (TA) in Blood Plasma
12 Weeks

Characterize the Pharmacokinetic Profile of FX006 and TCA IR \[Time Frame: Day 1 (pre-treatment,1, 2, 3, 4, 5, 6, 8,10, and 12 hrs. post-dose) and Days 2, 3, 5, 8, 15, 22, 29, 57,and 85\] For the PK analysis and individual concentration vs. time plots, a concentration that is BLOQ is assigned a value of zero if it occurs in a profile before the first measurable concentration. If a BLOQ value occurs after a measurable concentration in a profile and is followed by a value above the lower limit of quantification, then the BLOQ is treated as missing data. If a BLOQ value occurs at the end of the collection interval (after the last quantifiable concentration) it is set to zero. If two BLOQ values occur in succession after Cmax, the profile is deemed to have terminated at the first BLOQ value and any subsequent concentrations are set to zero for PK calculations

Total Number of Treatment Emergent Adverse Events
12 Weeks

Analyses of adverse events (AE) were performed for events considered treatment-emergent (TE). TE was defined as any AE with onset after administration of the 1st dose of study drug or any event present at baseline but worsened in intensity through the study. Severity was graded by the PI using the Common Terminology Criteria for AEs Version 4.0. Grading went from Grade 1 (Mild) to Grade 5 (Death Related to AE).

Measure the Concentration of Triamcinolone Acetonide (TA) in Blood Plasma
43 days

Plasma drug concentrations (pg/mL) by Time Point across FX006 and TAcs treatment arms in plasma. For the PK analysis and individual concentration vs. time plots, a concentration that is BLOQ is assigned a value of zero if it occurs in a profile before the first measurable concentration. If a BLOQ value occurs after a measurable concentration in a profile and is followed by a value above the lower limit of quantification, then the BLOQ is treated as missing data. If a BLOQ value occurs at the end of the collection interval (after the last quantifiable concentration) it is set to zero. If two BLOQ values occur in succession after Cmax, the profile is deemed to have terminated at the first BLOQ value and any subsequent concentrations are set to zero for PK calculations

Incidence of Treatment Emergent Adverse Events
43 days

Safety analyses were conducted using the safety population. Analyses of adverse events will be performed for those events that are considered treatment emergent, where treatment emergent is defined as any adverse event with onset after the administration of study medication in the first knee through the end of the study or any event that was present at baseline but worsened in intensity through the end of the study. Severity of Adverse events were graded by the Principal Investigator using the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0. The grading went from Grade 1 (Mild) to Grade 5 (Death related to AE).

Change From Baseline for Average Blood Glucose (mg/dL)
Baseline and 72 Hours post intra-articular (IA) injection

Average blood glucose was analyzed with a mixed model for repeated measures (MMRM)

Synovial Fluid Drug Concentrations (pg/mL) by Time Point Pooled Across FX006 Cohorts and TCA IR in Synovial Fluid
Up to 20 Weeks

All baseline (pre-treatment) values and all post-baseline values recorded as below LLOQ (\<50 pg/mL) were set to zero. Geometric mean summary statistics were computed on adjusted concentration values. One (1) was added to each concentration value observed. BLQ values for the computation of geometric mean are included in the summary with a value of 1 (0+1).

Change From Baseline to Week 12 in the Weekly Mean of the Average Daily (24-hr) Pain Intensity Scores for 32 mg FX006 Versus Placebo
Baseline and Week 12

The pain intensity score is measured using an 11-point numeric rating scale (NRS), where 0 indicates "no pain"and 10 indicates "pain as bad as you can imagine."

Concentration of Triamcinolone Acetonide in Synovial Fluid
12 to 20 weeks

Analyses of synovial fluid drug concentrations were performed using the Synovial Fluid Drug Concentration Population. Values recorded as lower limit of quantification (LLOQ) (\< 50 pg/mL) were counted as half the value below limit of quantification (BLQ).

Change From Baseline in 24-hour Weighted Mean Serum Cortisol
Days 1-2, Days 14-15 (Week 2) and Days 42-43 (Week 6)

The primary pharmacodynamic endpoint was change from baseline (pre-dose) to Day 1-2, Day 14-15 (Week 2) and Day 42-43 (Week 6) in 24-hour weighted mean serum cortisol. This is defined as AUC over the 0-24 hour measurement period divided by 24

Characterize the Pharmacokinetic Profile of FX006 and TCA IR
Day 1 (1, 2, 4, 6, 8, 12 and 24 hours post dose) and Days 3, 4, 5, 8, 15, 22, 29, 36 and 43

Concentrations below the limit of quantification of 50 pg/mL were treated as 0.

Change From Baseline to Week 8 in Weekly Mean of the Average Daily (24-hour) Pain Intensity Score for FX006 60 mg vs TCA IR 40 mg
8 weeks

The pain intensity score is measured using an 11-point numeric rating scale (NRS), where 0 indicates "no pain" and 10 indicates "pain as bad as you can imagine."

Change From Baseline to Week 10 in Weekly Mean of the Average Daily (24-hour) Pain Intensity Score for FX006 60 mg vs TCA IR 40 mg
10 weeks

The pain intensity score is measured using an 11-point numeric rating scale (NRS), where 0 indicates "no pain" and 10 indicates "pain as bad as you can imagine."

Change From Baseline to Week 12 in Weekly Mean of the Average Daily (24-hour) Pain Intensity Score for FX006 60 mg vs TCA IR 40 mg
12 weeks

The pain intensity score is measured using an 11-point numeric rating scale (NRS), where 0 indicates "no pain" and 10 indicates "pain as bad as you can imagine."

Secondary Endpoints

Change from Baseline on the Worst Daily Pain (24-hr) mean score (0-10 Numeric Rating Scale (NRS); 0 = no pain, 10 = worst possible pain) at Week 12 for ZILRETTA relative to TCA-IR
Week 12
Change from Baseline on the Worst Daily Pain (24-hr) mean score (0-10 Numeric Rating Scale (NRS); 0 = no pain, 10 = worst possible pain) at Week 18 for ZILRETTA relative to TCA-IR
Week 18
Change from Baseline on the Worst Daily Pain (24-hr) mean score (0-10 Numeric Rating Scale (NRS); 0 = no pain, 10 = worst possible pain) at Week 2 for ZILRETTA relative to placebo
Week 2
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Study Design & Arms

AllocationRANDOMIZED
MaskingSINGLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
ZILRETTAEXPERIMENTAL100 subjects will receive 32 mg ZILRETTA
PlaceboPLACEBO_COMPARATOR50 subjects will receive normal saline placebo
FX006 32 mgEXPERIMENTALSingle intra-articular (IA) injection of FX006 32 mg
FX006 32mgEXPERIMENTALSingle 5 mL intra-articular (IA) injection Extended-release Formulation
Normal SalinePLACEBO_COMPARATORSingle 5 mL intra-articular (IA) injection
TCA IR 40 mgACTIVE_COMPARATORSingle 1 mL intra-articular (IA) injection TCA IR 40 mg: Immediate-release formulation
FX006EXPERIMENTAL -
TAcs 40 mgACTIVE_COMPARATORSingle intra-articular (IA) injection of TAcs 40 mg
FX006 16 mgEXPERIMENTALSingle 5 mL intra-articular (IA) injection Extended-release formulation
FX006 10 mgEXPERIMENTALSingle 3 mL intra-articular (IA) injection
FX006 40 mgEXPERIMENTALSingle 3 mL intra-articular (IA) injection
FX006 10mgEXPERIMENTALSingle 3 mL intra-articular (IA) injection Extended-release formulation
FX006 40mgEXPERIMENTALSingle 3 mL intra-articular (IA) injection Extended-release formulation
FX006 60 mgEXPERIMENTALSingle 3 mL intra-articular (IA) injection Extended-release formulation
TCA IR (40 mg)ACTIVE_COMPARATORSingle 1 mL intra-articular (IA) injection Immediate-release formulation

Interventions

NameTypeDescription
ZILRETTADRUGIA injection of 32 mg ZILRETTA
PlaceboOTHERIA injection of placebo (normal saline)
FX006 32 mgDRUGExtended-release 32 mg FX006 IA injection
FX006DRUGSingle 5 mL IA injection
TCA IR 40DRUGSingle 1 mL IA injection
TAcs 40 mgDRUGImmediate-release 40mg TAcs IA injection
TCA IR 40 mgDRUGSingle 1 mL IA injection
FX006 16 mgDRUGSingle 5 mL IA injection
FX006 10 mgDRUGExtended-release formulation
FX006 40 mgDRUGExtended-release formulation
FX006 60 mgDRUGsingle 3 mL IA injection
TCA IRDRUGSingle 1 mL intra-articular injection
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Eligibility Criteria

Age Range50 Years to 80 Years
SexALL
Healthy VolunteersNo
Study Sites32

Inclusion Criteria To be included in the trial, participants must fulfill the following criteria: 1. Written informed consent has been obtained prior to initiating any study-specific procedures. 2. Willingness and ability to comply with the study procedures and visit schedules and ability to follo...

Countries:United StatesUnited KingdomAustraliaCanadaDenmarkEstoniaHong KongLithuaniaRomania
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Frequently asked questions about ZILRETTA

What is ZILRETTA used for in glenohumeral osteoarthritis?

ZILRETTA is an investigational small molecule being studied for the treatment of glenohumeral osteoarthritis, a type of shoulder osteoarthritis. It is currently in Phase 3 clinical development and has not been approved by the FDA for this indication.

What does ZILRETTA target?

ZILRETTA targets the glucocorticoid receptor. It is a small molecule designed to interact with this receptor, which plays a role in inflammatory pathways relevant to osteoarthritis. The drug is being evaluated for its effects in patients with glenohumeral osteoarthritis.

Who makes ZILRETTA?

ZILRETTA is being developed by Pacira BioSciences, Inc., a biopharmaceutical company traded on the Nasdaq under the ticker symbol PCRX. The company is conducting clinical trials to evaluate the drug for the treatment of glenohumeral osteoarthritis.

What phase is ZILRETTA in?

ZILRETTA is currently in Phase 3 clinical development. It is an investigational drug for glenohumeral osteoarthritis and has not received FDA approval. The ongoing Phase 3 trial is active but not recruiting participants.

What clinical trials is ZILRETTA in?

ZILRETTA is being evaluated in a Phase 3 clinical trial with the identifier NCT06269705, titled "ZILRETTA in Subjects With Shoulder Osteoarthritis." The trial is active but not recruiting, with an estimated enrollment of 150 participants in the United States.

Is ZILRETTA the same as triamcinolone acetonide extended-release?

ZILRETTA is a brand name for triamcinolone acetonide extended-release injectable suspension. It is a glucocorticoid receptor agonist used for osteoarthritis pain. In the context of glenohumeral osteoarthritis, it is being studied under the ZILRETTA name in clinical trials.