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Fasinumab

Phase 3

Osteoarthritis of the Knee or Hip | Small molecule | Musculoskeletal |Regeneron Pharmaceuticals, Inc.|Last Updated: Oct 13, 2023

Success Probability

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Trial Design

RandomizedDouble-BlindCONTROLLEDDMC
Total Trials1
Total Enrollment5,331

FDA Designations

No designations recorded

Clinical trial landscape

Fasinumab · 6 trials · 5 indications

Phase 3 3Phase 2 2Phase 1 1
NCT03304379Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Adults With Pain From Osteoarthritis of the Knee or HipOsteoarthritis, Knee
COMPLETED1,650 Analytics
NCT03161093A Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Naproxen for Treatment of Adults With Pain From Osteoarthritis of the Knee or HipOsteoarthritis, Knee
COMPLETED3,307 Analytics
NCT02683239Long-Term Safety and Efficacy Study of Fasinumab in Patients With Pain Due to Osteoarthritis (OA) of the Knee or HipOsteoarthritis of the Knee or Hip
COMPLETED5,331 Analytics
PHASE3COMPLETED
Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Nonsteroidal Anti-inflammatory Drugs (NSAIDs) for Treatment of Adults With Pain From Osteoarthritis of the Knee or Hip
Osteoarthritis, KneeUnlock trial analytics
PHASE3COMPLETED
A Study to Determine the Safety and the Efficacy of Fasinumab Compared to Placebo and Naproxen for Treatment of Adults With Pain From Osteoarthritis of the Knee or Hip
Osteoarthritis, KneeUnlock trial analytics
PHASE3COMPLETED
Long-Term Safety and Efficacy Study of Fasinumab in Patients With Pain Due to Osteoarthritis (OA) of the Knee or Hip
Osteoarthritis of the Knee or HipUnlock trial analytics

Study Endpoints

Primary Endpoints

Change From Baseline in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain Subscale Scores up to Week 24 in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24

WOMAC pain subscale was a 5-item questionnaire used to assess the amount of pain experienced due to osteoarthritis in the index joint (knee or hip) in past 48 hours. It was calculated as the mean of the scores from the 5 individual questions scored on a numerical rating scale (NRS) of 0 (no pain) to 10 (higher pain), where higher scores indicated higher pain.

Change From Baseline in WOMAC Physical Function Subscale Scores up to Week 24 in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24

Physical function referred to participant's ability to move around and perform usual activities of daily living. The WOMAC physical function subscale was a 17-item questionnaire used to assess the degree of difficulty experienced due to osteoarthritis in index joint (knee or hip) during past 48 hours. It was calculated as mean of the scores from 17 individual questions scored on a NRS of 0 (minimum difficulty) to 10 (maximum difficulty), where higher scores indicated maximum difficulty.

Change in the WOMAC Pain Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg SC Q4W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change in the WOMAC Physical Function Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg Q4W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change in the WOMAC Pain Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg SC Q8W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change in the WOMAC Physical Function Subscale Scores From Baseline to Week 16 in Participants Treated With Fasinumab 1mg Q8W Compared With That of Participants Treated With Placebo
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Number of Participants With Any Treatment-Emergent Adverse Event (TEAE)
Baseline up to week 52
Number of Participants With Any Serious TEAE
Baseline up to week 52
Number of Participants With Any Adverse Event (AE) up to Week 72
Baseline up to week 72
Number of Participants With Any Serious AE up to Week 72
Baseline up to week 72
Number of Participants With Adjudicated Arthropathy (AA)
Baseline up to week 52 and week 72

Adjudicated arthropathy (AA) is a composite term that encompasses the following conditions: Rapidly progressive OA type 1 and 2, Subchondral insufficiency fractures, and Primary Osteonecrosis. AAs were also evaluated to determine if they met Destructive Arthropathy criteria.

Number of Participants With Adjudicated Arthropathy (AA) Meeting Destructive Arthropathy (DA) Criteria
Baseline up to week 52 and week 72

DA is a unique clinical form of rapidly destructive arthropathy over and above that seen in the normal progression of OA. DA criteria can be associated with Rapidly Progressive OA type 2, Subchondral Insufficiency fracture, and Primary Osteonecrosis confirmed by an arthropathy adjudication committee.

Number of Participants With at Least One Peripheral Sensory Event That Required a Neurology Consultation
Baseline up to week 72

Any participant with a peripheral sensory event that persisted for 2 months was referred for a neurology or other specialty consultation and reported as an adverse event of special interest (AESI).

Number of Participants With Sympathetic Nervous System (SNS) Dysfunction
Baseline up to week 72

Potential events of sympathetic nervous system (SNS) dysfunction were monitored throughout the study through physical examination, AE reporting, assessment of orthostatic hypotension, and the Survey of Autonomic Symptoms. Sympathetic nervous system dysfunction was diagnosed after consultation with an appropriate specialist, such as a neurologist and/or cardiologist.

Number of Participants With at Least One All-Cause Joint Replacement (JR) Surgery
Baseline up to weeks 52, 72, and end of study (52 weeks post last dose)

All joint replacement surgery events regardless of cause at weeks 52 and 72. An end of study phone contact was also conducted approximately 52 weeks following the last dose of study drug.

Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values up to Week 52
Baseline to week 52

Number of participants with potentially clinically significant abnormal values in hematology, chemistry, and urinalysis during the treatment period were reported. Clinical significance was determined by the investigator.

Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values Post-Treatment up to Week 72
End of treatment up to week 72

Number of participants with potentially clinically significant abnormal values in hematology, chemistry, and urinalysis during the post-treatment period were reported. Clinical significance was determined by the investigator.

Number of Participants With Anti-drug Antibody (ADA) up to Week 72
Baseline up to week 72

Immunogenicity was characterized by ADA responses \& titers. Responses categories: Negative - ADA negative response at all time points, regardless of missing samples; Pre-existing immunoreactivity - ADA positive response at baseline with all post first dose negative results or positive response at baseline with all post first dose ADA responses less than (\<) 9-fold over baseline titer levels; Treatment-boosted response - positive response in the assay post first dose, greater than or equal to (≥) 9-fold over baseline titer levels, when baseline results are positive; Treatment-emergent response - ADA positive response in the fasinumab ADA assay post first dose when baseline results = negative or missing.

Change From Baseline to Week 16 in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Pain Subscale Score
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change From Baseline to Week 16 in WOMAC Physical Function Subscale Score
Baseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change From Baseline in Peroneal Motor Nerve Conduction Velocity at Week 16
Baseline, Week 16

Peroneal motor nerve conduction velocity was evaluated by electrical stimulation of the nerve and recorded the compound muscle action potential from surface electrodes overlying a muscle supplied by the nerve. Change from baseline in peroneal motor nerve conduction velocity at Week 16 was reported.

Change From Baseline in Peroneal Motor Nerve Action Potential Amplitude at Week 16
Baseline, Week 16

Peroneal motor nerve action potential amplitude was evaluated at ankle by electrical stimulation of the nerve and recorded the compound muscle action potential from surface electrodes overlying a muscle supplied by the nerve. Change from baseline in peroneal motor nerve action potential amplitude at Week 16 was reported.

Change From Baseline in Sural Sensory Nerve Conduction Velocity at Week 16
Baseline, Week 16

Sural sensory nerve conduction velocity was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline in sural sensory nerve conduction velocity at Week 16 was reported.

Change From Baseline in Sural Sensory Nerve Action Potential Amplitude at Week 16
Baseline, Week 16

Sural sensory nerve action potential amplitude was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline in sural sensory nerve action potential amplitude at Week 16 was reported.

Change From Baseline in Ulnar Sensory Nerve Conduction Velocity at Week 16
Baseline, Week 16

Ulnar sensory nerve conduction velocity was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline in ulnar sensory nerve conduction velocity at Week 16 was reported.

Change From Baseline in Ulnar Sensory Nerve Action Potential Amplitude at Week 16
Baseline, Week 16

Ulnar sensory nerve action potential amplitude was evaluated by electrically stimulating sensory fibers and recorded the nerve action potential at a point further along that nerve. Change from baseline ulnar sensory nerve action potential amplitude at Week 16 was reported.

Change From Baseline to Week 16 in the Average Daily Low Back Pain Index Numeric Rating Scale (LBPI NRS) Score
Baseline to Week 16

Average daily low back pain (LBP) was assessed on an 11-point numeric rating scale (NRS) and was defined as the average of the non-missing daily LBPI NRS scores for the 7 days before and including nominal visit. Participants described their average low back pain during the past 24 hours on a scale ranging from 0 (no pain) to 10 (worst possible pain), where higher scores indicate higher pain.

The primary endpoint in the study is the incidence and severity of treatment emergent adverse events (TEAEs) in participants treated with fasinumab or placebo.
Baseline to week 16 (End of Study)

Secondary Endpoints

Percentage of Participants With Greater Than or Equal to (≥) 30 Percent (%) Reduction From Baseline up to Week 24 in WOMAC Pain Subscale Score in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24
Change From Baseline in Patient Global Assessment (PGA) Score up to Week 24 in Participants Treated With Fasinumab Compared to Placebo
Baseline up to Week 24
Change From Baseline in WOMAC Pain Subscale Scores up to Week 24 in Participants Treated With Fasinumab Compared to Participants Treated With NSAIDs
Baseline up to Week 24
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Study Design & Arms

AllocationRANDOMIZED
MaskingTRIPLE
ModelPARALLEL
PurposeTREATMENT

Treatment Arms

ArmTypeDescription
Dosing regimen 1EXPERIMENTAL -
Dosing regimen 2EXPERIMENTAL -
Dosing regimen 3EXPERIMENTAL -
Dosing regimen 4EXPERIMENTAL -
Fasinumab dosing regimen 1EXPERIMENTALFasinumab Subcutaneous (SC) dosing regimen 1 and naproxen-matching placebo oral
Fasinumab dosing regimen 2EXPERIMENTALFasinumab SC dosing regimen 2 and naproxen-matching placebo oral
Fasinumab-matching placebo and naproxenEXPERIMENTAL -
Fasinumab-matching placebo and naproxen-matching placeboEXPERIMENTAL -
PlaceboEXPERIMENTAL -
FasinumabEXPERIMENTAL -
Fasinumab 6 mg SC Q4W and Placebo IV Q8WEXPERIMENTALParticipants randomized to the fasinumab 6 mg SC Q4W arm received fasinumab 12 mg SC on Day 1 (loading dose) and then 6 mg SC (planned maintenance dose) at Weeks 4, 8, and 12 for a total of 4 doses. Matching placebo was received via intravenous (IV) infusion Q8W on Day 1 and at Week 8.
Fasinumab 9 mg SC Q4W and Placebo IV Q8WEXPERIMENTALParticipants randomized to the fasinumab 9 mg SC Q4W arm received 18 mg SC on day 1 (loading dose) and then 9 mg SC (planned maintenance dose) at weeks 4, 8, and 12 for a total of 4 doses. Matching placebo IV Q8W was received on Day 1 and at Week 8.
Fasinumab 9 mg IV Q8W and Placebo SC Q4WEXPERIMENTALParticipants randomized to the fasinumab 9 mg IV Q8W arm received IV infusions of fasinumab 9 mg on Day 1 and Week 8, for a total of 2 doses. Matching placebo SC Q4W was received on day 1 and at weeks 4, 8, and 12.
Placebo SC Q4W and Placebo IV Q8WEXPERIMENTALParticipants randomized to the matching placebo subcutaneously (SC) every four weeks (Q4W) arm received SC placebo in a manner similar to the SC loading dose of the active groups (placebo loading dose) on Day 1 and then an SC injection of placebo at weeks 4, 8, and 12 for a total of 4 doses. Matching placebo intravenously (IV) every 8 weeks (Q8W) was received on Day 1 and at Week 8.
Cohort 1EXPERIMENTALParticipants in this cohort will receive dose 1 of Fasinumab or placebo
Cohort 2EXPERIMENTALParticipants in this cohort will receive dose 2 of Fasinumab or placebo
Cohort 3EXPERIMENTALParticipants in this cohort will receive dose 3 of Fasinumab or placebo
Cohort 4EXPERIMENTALParticipants in this cohort will receive dose 4 of Fasinumab or placebo
Cohort 5EXPERIMENTALParticipants in this cohort will receive dose 5 of Fasinumab or placebo

Interventions

NameTypeDescription
FasinumabDRUGSolution for injection in pre-filled syringe
DiclofenacOTHERNSAID active comparator (capsule)
CelecoxibOTHERNSAID active comparator (capsule)
Matching placeboDRUGFasinumab-matching placebo (solution for injection in pre-filled syringe); NSAID-matching placebo (capsule)
NaproxenDRUGPharmaceutical form: Capsule
Fasinumab-matching placeboDRUGSolution for injection in pre-filled syringe
Naproxen-matching placeboDRUGCapsule
PlaceboDRUGParticipants will receive sub-cutaneous (SC) injections of matching placebo
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Eligibility Criteria

Age Range18 Years to N/A
SexALL
Healthy VolunteersNo
Study Sites71

Key Inclusion Criteria (additional criteria may apply at screening): 1. A clinical diagnosis of osteoarthritis (OA) of the knee or hip based on the American College of Rheumatology criteria with radiologic evidence of OA (K-L score ≥2 for the index joint) at the screening visit. 2. Willing to disco...

Countries:United StatesDenmarkGermanyHungaryLithuaniaPolandRomaniaRussiaSouth AfricaSpainUkraineUnited KingdomBulgariaChileColombiaEstoniaHong KongItalyMexicoPeruSwedenCanadaCzechia
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Frequently asked questions about Fasinumab

What is Fasinumab used for?

Fasinumab is an investigational small molecule being studied for the treatment of pain associated with osteoarthritis of the knee or hip, chronic low back pain, and in healthy volunteers. It has been evaluated in clinical trials for these conditions, though it is not yet approved and remains in clinical development.

Who makes Fasinumab?

Fasinumab is being developed by Regeneron Pharmaceuticals, Inc., a biopharmaceutical company traded on the Nasdaq under the ticker symbol REGN. Regeneron has sponsored multiple clinical trials to evaluate the safety and efficacy of Fasinumab for pain-related conditions.

What phase is Fasinumab in?

Fasinumab has completed Phase 2 and Phase 3 clinical trials, but it is not approved and remains investigational. The most advanced trials were Phase 3 studies for osteoarthritis pain of the knee or hip, which have been completed. No active trials are currently listed.

What clinical trials has Fasinumab been in?

Fasinumab has been studied in several completed trials, including NCT02620020 for chronic low back pain, NCT03161093 and NCT03304379 for osteoarthritis of the knee or hip, and NCT03691974 for peripheral nerve function in osteoarthritis patients. These trials enrolled over 5,000 participants.

Is Fasinumab the same as any other drug?

Fasinumab is not known to have alternative names. It is a distinct investigational compound developed by Regeneron Pharmaceuticals. No other names for this drug have been reported in clinical trial registrations.

How does Fasinumab work?

Fasinumab is a small molecule, but its specific molecular target has not been disclosed in the available information. Clinical trials have focused on its efficacy and safety for pain relief in osteoarthritis and low back pain, without detailing its mechanism of action.