NANOVAE to Treat Knee Osteoarthritis (KOA)

Starting soon · Phase 1/Phase 2 · Has a placebo group

Conditions studied: Knee Osteoarthritis

In brief

The below summarizes relevant information for investigator(s) to consider the use of Allogenic Human Amniotic Fluid product in a clinical protocol detailing study design and conduct for a phase I/II randomized, double-blinded, placebo-controlled clinical trial to evaluate the safety and potential efficacy of NANOVAE injected intra-articularly in patients suffering from knee osteoarthritis. The IB will be reviewed annually and amended when further information becomes available. Osteoarthritis (OA) is a degenerative disease of the joints that affects millions of people worldwide, yet its exact causes are not fully understood. Middle-aged to elderly individuals are often the most impacted by OA, which primarily affects the knee, hip, spine, and joints in the fingers. Among these, knee osteoarthritis (KOA) is the most common form, causing pain, stiffness, and reduced functionality, and it is a major contributor to chronic bone and muscle pain. It is also a leading cause of disability in adults who are not living in institutions. Treatment for KOA is challenging due to its resistance to medications, procedures, and surgeries. The primary objective is to alleviate pain and enhance overall function. However, since there is currently no cure for OA, the need for an effective therapy remains urgent. Healthcare professionals often encounter patients whose pain may result from an inflammatory response triggered by injury or disease. Research suggests that regenerative medicine, utilizing techniques like stem cells, platelet-rich plasma (PRP), amniotic fluid, and cytokine modulation, holds promise for treating KOA. OA is associated with an increase in pro-inflammatory substances such as interleukin (IL)-1, IL-6, tumor necrosis factor-alpha (TNF-α), matrix metalloproteinases (MMPs), nitric oxide (NO), reactive oxygen species (ROS), and cytokine-inducible cyclooxygenase-2 (COX-2). These inflammatory agents affect various cell types within the affected joints, including chondrocytes, osteoblasts, osteoclasts, synoviocytes, and macrophages. Some miRNAs, which are downregulated in OA, have been identified as protective factors. For example, miR-130 helps regulate TNF-α levels, while miR-149 controls several inflammatory cytokines such as IL-1, IL-6, and TNF-α. The breakdown of the cartilage matrix is a key characteristic of OA. MMP-13, a member of the MMP family, plays a significant role in degrading the collagen network during OA development. Several miRNAs, including miR-27b, miR-27a, miR-148a, miR-320, miR-127-5p, and miR-411, are downregulated in OA and target the mRNA of this proteinase. It is important to note that a single miRNA can regulate multiple target genes associated with OA progression. For instance, miR-105 and miR-148, both downregulated in OA, target genes such as Runx2, ADAMTS4, ADAMTS5, ADAMTS7, ADAMTS12, MMP-13, and COL10, implying their potential protective roles. Several studies have shown a link between certain miRNAs, aging, and the progression of OA. For example, miR-320c is downregulated in aging OA samples and regulates ADAMTS5, suggesting that this miRNA may serve as a protective factor by enhancing chondrogenesis.

Key facts

Study ID

NCT06606561

Run by

Nova Vita Laboratory

People needed

24

Starts

2026-10-01

Expected to finish

2027-10-01

Last updated by the study team

2026-04-13

Who can join

Age: 21 and older, up to 75. Sex: any. Healthy volunteers: not accepted.

You may qualify if…

• Age eligible for study: 21 to 75 years
• Gender eligible for study: All
• Study subjects must be willing to give written informed consent to participate in the study and sign the Health Insurance Portability and Accountability Act (HIPAA) authorization before any study procedures are performed.
• Subjects have a diagnosis of OA in at least one knee defined as Grade II or III on Kellgren-Lawrence (K-L) grading scale which is confirmed by posterior-anterior, weight-bearing, fixed flexion radiography with 10o caudal beam angulation.
• Subjects with VAS pain score ≥40 mm on screening day will be included.
• Subjects had one or more of the following SOC treatments within the previous 12 months will be included:
• weight loss
• physical therapy
• anti-inflammatory medications - oral, injections and topical
• Body mass index (BMI) \< 45kg/m2
• Subjects must be available for all specified assessments at the study site through the completion of the study.
• For Women of Child-Bearing Potential (WOCBP) only, willingness to use FDA-recommended birth control until 6 months post treatment. The FDA-approved and cleared methods for birth control are listed below:
• Permanent Sterilization
• Long-Acting Reversible Contraceptives (LARC)
• Contraceptive Injection
• Short-Acting Hormonal Methods
• Barrier Methods
• Emergency Contraception https://www.fda.gov/consumers/free-publications-women/birth-control
• Any male subject must agree to use contraceptives and not donate sperm during the study.
• Patient may be eligible for treatment of both knees if criteria is met for both

You may not qualify if…

• Subjects have evidence of significant and unstable cardiac dysfunction, e.g. acute myocardial infarction and hypertension with uncontrolled blood pressure over 140/90 will be excluded.
• Subjects at screening with white blood cell count \< 4 x 109 cells/L, hematocrit \<30%, and platelets \<150 x 109 /L will be excluded.
• Subjects with poorly controlled diabetes (hemoglobin A1C \> 7.5 or fasting blood glucose of \>200) in last 6 months will be excluded.
• Individuals on dialysis or uncontrolled renal disease will be excluded.
• Subjects with abnormal hematology, serum chemistry, or urinalysis screening laboratory results will be excluded.
• Subjects with history of, or ongoing, autoimmune disorder that requires treatment with an immunosuppressive medication will be excluded.
• Subjects had knee surgery on the targeted knee within 12 months prior to screening and /or planned knee surgery during the study will be excluded.
• Subjects have a body mass index greater than 45 kg/m2 will be excluded.
• Subjects whose knee pain is caused by, (i) diffuse edema, extra articular causation (ii) displaced meniscus tear, (iii) full thickness articular cartilage lesion greater than 1 cm in any direction, or (iv) osteochondritis dissecans will be excluded.
• Subjects have rheumatoid arthritis, psoriatic arthritis, or have been diagnosed with any other auto-immune disorders that could be the cause of their knee pain will be excluded.
• Subjects which have evidence or history of malignancy except those who are successfully treated in situ or basal cell skin cancers will not be excluded.
• Subjects with a history of clotting disorder, anticoagulation therapy that cannot be stopped as prior to infusion will be excluded.
• Subjects have evidence of liver dysfunction manifested as alkaline phosphatase greater than 345 u/L, total bilirubin greater than 1.65 mg/dL, ALT greater than 275 units/L and/or AST great than 240 units/L will be excluded.
• Subjects have or had an active infection requiring systemic antibiotics within 2 weeks on enrollment in the study will be excluded.
• Subjects currently taking anticoagulant therapy (excluding Plavix or Aspirin) will be excluded.
• Subjects have received an intra-articular hyaluronic acid (HA) or platelet rich plasma (PRP) for the treatment of OA of the target knee within 12 weeks prior to screening will be excluded.
• Subjects have used an investigational drug or had surgical intervention within 12 weeks of the study enrollment will be excluded.
• Subjects that are unwilling to stop taking prescription or over the counter pain medication for Osteoarthritis for 7 days prior to any visit will be excluded. Subjects will be permitted to take medications for non-osteoarthritis condition (excluding the one's listed under "Concomitant Medication").
• Subjects needing or at high risk of requiring systemic steroids during the course of study will be excluded except systemic use of corticosteroid administration for COVID-19 or flare up of non-arthritic condition.
• Complete information of dose and timeframe of the medication use will be documented in case report forms (CRF).
• Be a female who is pregnant, nursing, or of childbearing potential while not practicing effective contraceptive methods.
• Subjects who are unable to complete all the testing required for the study will be excluded.
• Subjects on active listing (or expected future listing) for transplant of any organ will be excluded.
• Be a solid organ transplant recipient. This does not include prior cell-based therapy (\>12 months prior to enrollment), bone, skin, ligament, tendon or corneal grafting. Have a history of organ or cell transplant rejection.
• Subjects with history of drug abuse (illegal "street" drugs except marijuana (If it is legal use in states where patient resides), or prescription medications not being used appropriately for a pre-existing medical condition or alcohol abuse (≥ 5 drinks/day for ˃ 3 months).

Where it is running

• Bluetail Medical Group — Chesterfield, Missouri, United States

Full record on ClinicalTrials.gov

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