Functional Exercise Response on osteoArthritis Relaxation Imaging

Osteoarthritis Clinical Trial

— FERARI  

Official title:

Functional Exercise Response on osteoArthritis Relaxation Imaging

Clinical Trial Details — Status: Active, not recruiting

Administrative data

• NCT number: NCT03657303
• Other study ID #: A094874
• Status: Active, not recruiting
• Start date: November 21, 2019
• Est. completion date: December 2022

Study information

• Verified date: July 2022
• Source: Cambridge University Hospitals NHS Foundation Trust
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Osteoarthritis (OA) is the most prevalent cause of mobility impairment and disability in the elderly. Indications at early stages of OA include decreased organisation of the collagen matrix, loss of proteoglycans and increased hydration. Late-stage joint disease can be diagnosed with X-ray, CT, and conventional MRI, but there are no validated methods to image early changes in cartilage microstructure, which are direly needed in early phase clinical development. Newly developed therapies and evaluation techniques are required at earlier stages of disease to offset the growing numbers and costs of end-stage disease.

MRI can probe soft-tissue with physical measurements that are not available through other methods. Quantitative MRI signal relaxation properties are particularly promising for assessing early changes in the cartilage composition. These relaxation properties are sensitive to water content and cartilage macromolecular structure.

Mechanical joint-loading and exercise affects quantitative MRI through cartilage compression and nonuniform deformation. A study measuring MRI relaxation times and using static joint-loading weights has shown differences between OA and healthy subjects. Cartilage volume, which is expected to be related to these relaxation times, recovers within an hour after exercise in healthy runners, with the menisci lagging in their volume recovery rate. Previous exercise studies have not measured post-exercise cartilage recovery using compositional techniques, such as physiologically-sensitive T1ρ and T2, nor probed compositional responses with OA subjects.

The investigators will examine a single knee of an initial 18 participants with MR. Participants will be drawn from two groups: (1) 12 participants aged 40-60 years old with clinical and x-ray features of OA and (2) 6 control subjects (matched to cases for age, sex and body mass index in a 1:2 ratio) who do not have clinical features of OA.

Participants will undergo an initial (baseline) MR examination, followed by repeat MR examinations at approximately 1 month and 1 year following the baseline examination.

This will allow the investigators to explore the possibility of mechanical joint-loading and exercise to differentiate early stage OA from healthy subjects and assess both the reliability of the MR measurements and the expected progression in the MR measurements in OA subjects in the absence of any disease-modifying intervention.

Recruitment information / eligibility

• Status: Active, not recruiting
• Enrollment: 18
• Est. completion date: December 2022
• Est. primary completion date: December 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 40 Years to 60 Years

Eligibility

Group 1 Inclusion Criteria:

• Meets ACR criteria for OA Kellgren-Lawrence grade 2-3 on knee radiograph

• Neutral alignment

• Single symptomatic joint

• Aged 40-60 years old

• Ambulatory and in good general health

• Knee able to fit inside in-vivo knee coil (approx. 18 cm diameter)

Group 2 Inclusion Criteria:

• No current symptoms of knee pain or stiffness or other clinical features of OA

• Aged 40-60 years old

• Written consent to participate in the study

• Ambulatory and in good general health

• Knee able to fit inside in-vivo knee coil (approx. 18 cm diameter)

Exclusion Criteria for both groups:

• History of ipsilateral lower limb fracture

• History of ipsilateral lower limb surgery (including arthroscopy)

• Metabolic bone disease

• Inflammatory arthritis

• Haematological malignancy

• Paget's disease

• Bone metastases

• Contraindication to MR imaging (e.g. pacemaker, severe claustrophobia)

• No pregnant patients will be included

• Unable to consent

Related Conditions & MeSH terms

• Osteoarthritis

Intervention

Device:
• Magnetic resonance imaging (MRI)
Participants will undergo an initial (baseline) MR examination, followed by repeat MR examinations at approximately 1 month and 1 year following the baseline examination.

Locations

Country	Name	City	State
United Kingdom	Addenbrooke's Hospital	Cambridge	Cambridgeshire

Sponsors (1)

Lead Sponsor	Collaborator
Cambridge University Hospitals NHS Foundation Trust

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Establish effect sizes for MR parameters in OA patients compared to healthy volunteers.		1 year
Secondary	Establish effect sizes for MR parameters in subjects with OA at 1 year compared to baseline.		1 year
Secondary	Establish reliability of the MR protocol and analysis techniques.	Test-Retest Reliability	1 month - 1 year