A Phase 2b/3a Study to Evaluate the Efficacy and Safety of JointStem in Patients Diagnosed as Knee Osteoarthritis
A Phase 2b/3a Study to Evaluate the Efficacy and Safety of JointStem in Patients Diagnosed as Knee Osteoarthritis
This study is a double-blind, randomized, placebo controlled, multi-center, superiority study
 to evaluate the efficacy and safety of JointStem, autologous adipose tissue derived
 mesenchymal stem cells (AdMSC), in patients diagnosed as knee osteoarthritis. Following a
 2-week screening period, approximately 140 subjects will be randomly assigned into one of the
 following two arms in a 1:1 ratio (1 JointStem : 1 Placebo). After each subject completes
 48-Weeks visit (Visit 8) and the data management team confirms all individual data have no
 issue, the individual database will be locked and the blinding will be open for the
 statistical analysis.
Study Procedures:

 -  Visit 1 (Week -7) - Screening

 -  Visit 2 (Week -5) - Baseline and Randomization (Lipoaspiration)

 -  Visit 3 (Week 0) - Treatment (Intra-articular injection)

 -  Visit 4 (Week 4) - 4 weeks follow-up

 -  Visit 5 (Week 12) - 12 weeks follow-up

 -  Visit 6 (Week 24) - 24 weeks follow-up

 -  Visit 7 (Week 36) - 36 weeks follow-up

 -  Visit 8 (Week 48) - 48 weeks follow-up (End of Study)
Inclusion Criteria:

 -  Subject who had osteoarthritis of knee diagnosed (according to the clinical and
 American College of Rheumatology Criteria)

 -  Subject who has ≥ 34 on WOMAC function score at Screening and Baseline

 -  Subject who has knee pain ≥ 50 mm out of 100 mm on VAS (Visual Analog Scale) at
 Screening and Baseline

 -  Subject who has radiographic evidence of grade 3 osteoarthritis in one knee and grade
 1 or 2 in the other knee based on the Kellgren and Lawrence radiographic criteria.

 -  Subjects whose knee pain persists for at least 12 weeks (about 3 months) prior to
 screening and does not improve symptoms with non-operative treatment options

 -  Subject who is willing to discontinue all pain medications for osteoarthritis except
 rescue medication (< acetaminophen 3.25 g per day) at least 72 hours prior to
 screening and throughout the duration of study

 -  Subject who is willing and able to give written informed consent for participation in
 the study

 Exclusion Criteria:

 -  Subject who has Body Mass Index (BMI) > 35 kg/m2

 -  Subject who has any of following clinically significant disease or has a medical
 history of past

 -  Uncontrolled comorbid disease under treatment

 -  Kidney diseases (glomerulonephritis, chronic renal failure, etc.)

 -  Liver diseases (acute and chronic liver diseases including fatty liver, liver
 cirrhosis, etc.)

 -  Endocrine diseases (hypothyroidism/hyperthyroidism, thyroiditis, diabetes insipidus,
 Cushing's disease, etc.)

 -  Subject who has any of following clinically significant disease

 -  Autoimmune diseases

 -  Paget's disease, ochronosis, acromegaly, hemochromatosis, or Wilson's disease

 -  Genetic diseases (hyperkinesia, collagen gene abnormality, etc.)

 -  Inflammatory joint disorders (e.g. rheumatoid inflammation)

 -  Infectious joint disorders (e.g. septic arthritis)

 -  Other joint disorders (e.g. gout, recurrent pseudogout, articular fracture, primary
 osteochondrosis, villonodular synovitis)

 -  Subject who has a history of cancer or is diagnosed with cancer and currently
 receiving cancer treatment

 -  Subject who is positive in pathogenic test (HIV, viral hepatitis, or syphilis)

 -  Subject who has heart diseases (myocardial infarction, coronary artery bypass graft
 surgery, arrhythmia, or other serious heart diseases) or has history of heart diseases
 within 6 months prior to Screening

 -  Subject who have received any intra-articular therapy in any joint within 6 months
 prior to Screening, or surgery on the relevant knee including articular endoscopic
 procedures within 6 months prior to Screening

 -  Subject who has history of prolotherapy, or platelet rich plasma injection within 6
 months prior to Screening

 -  Subject who have received long-acting hyaluronic acid injection (e.g. Synvisc-One®,
 etc.) within 12 months prior to Screening

 -  Subject who has history of stem cell therapy

 -  Subject who have significant lab abnormalities for the following parameters (If the
 value is within 10% of the listed laboratory exclusion criterion value and the value
 is considered not to be clinically significant by the investigator, the subject can be
 considered for enrollment):

 -  Serum ALT and AST > 2 x upper limit of normal

 -  Serum creatinine out of normal range

 -  PT/INR out of normal range

 -  Hemoglobin < 10 g/dL for female subject and hemoglobin < 11 g/dL for male subject

 -  Platelets out of normal range

 -  Subject for whom the investigator judges the lipoaspiration can cause any problem

 -  Subject who has history of local anesthetic allergy

 -  Subject who has taken anti-inflammatory drugs (prescription and non-prescription
 NSAIDs), symptomatic slow acting drugs (glucosamine, chondroitin sulfate, diacerhein
 etc.), or oral steroids (prednisone etc.) within 14 days prior to Screening (however,
 those who undergo a 14-day wash-out period can participate.)

 -  Subject who is an active drug/alcohol abuser

 -  Pregnant or breast-feeding women, or women or men who are not using appropriate method
 of contraception (appropriate method includes hormones, bilateral tubal ligation, and
 barrier method with spermicide, and intra-uterine device for women and vasectomy and
 barrier method with spermicide for men; subjects should agree to use appropriate
 method)

 -  Subject who is enrolled in any other clinical trials within 3 months from Screening

 -  Subject who the principal investigator considers inappropriate for the study due to
 any other reasons than those listed above