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CTRI Number  CTRI/2014/03/004474 [Registered on: 13/03/2014] Trial Registered Prospectively
Last Modified On: 06/08/2014
Post Graduate Thesis  No 
Type of Trial  Interventional 
Type of Study   Drug 
Study Design  Other 
Public Title of Study   A Clinical trial intended to compare two formulations of Diclofenac sodium topical Gel 1% along with placebo, in patients with knee osteoarthritis. 
Scientific Title of Study   A Multi-Center, Double-Blind, Vehicle-Controlled, Parallel-Group Study Comparing a Generic Diclofenac Sodium Topical Gel, 1% to Voltaren® Gel (Diclofenac Sodium Topical Gel) 1% in the Treatment of Subjects with Osteoarthritis of the Knee 
Trial Acronym   
Secondary IDs if Any  
Secondary ID  Identifier 
AM-DCG-001 version 3 dated 08-4-2013  Protocol Number 
 
Details of Principal Investigator or overall Trial Coordinator (multi-center study)  
Name  Dr Nikunj Patel 
Designation  Executive Vice President, Global Clinical Affairs 
Affiliation  Amneal Pharmaceuticals  
Address  Amneal Pharmaceuticals corporate office, 509-514, 5th Floor, Venus atlantis, nr. Safal Pegasus, Prahladnagar

Ahmadabad
GUJARAT
380015
India 
Phone  9925152301  
Fax    
Email  nikunj@amneal.com  
 
Details of Contact Person
Scientific Query
 
Name  Dr Prayag Shah 
Designation  Assistant General Manager, Global Clinical Affairs 
Affiliation  Amneal Pharmaceuticals 
Address  Amneal Pharmaceuticals Co. (I) Pvt. Ltd., Corporate Headquarters, 509-514, 5th floor, Venus Atlantis, Nr. Safal Pegasus, Prahladnagar, Ahmedabad – 380015

Ahmadabad
GUJARAT
380015
India 
Phone  8128671400  
Fax  79-26778315  
Email  prayags@amnealindia.com  
 
Details of Contact Person
Public Query
 
Name  IrshadulHaque 
Designation  General Manager, Global Clinical Affairs 
Affiliation  Amneal Pharmaceuticals 
Address  Amneal Pharmaceuticals Co. (I) Pvt. Ltd., Corporate Headquarters, 509-514, 5th floor, Venus Atlantis, Nr. Safal Pegasus, Prahladnagar, Ahmedabad – 380015

Ahmadabad
GUJARAT
380015
India 
Phone  8511183555  
Fax    
Email  irshad@amnealindia.com  
 
Source of Monetary or Material Support  
Amneal Pharmaceuticals  
 
Primary Sponsor  
Name  Amneal Pharmaceuticals  
Address  85 Adams Avenue Hauppauge, NY 11758  
Type of Sponsor  Other [US based generic pharmaceutical company] 
 
Details of Secondary Sponsor  
Name  Address 
NIL  NIL 
 
Countries of Recruitment     India  
Sites of Study  
No of Sites = 35  
Name of Principal Investigator  Name of Site  Site Address  Phone/Fax/Email 
Dr Pardha Saradhi  Andhra Medical College  Andhra Medical college, Department of Orthopedics, Clinical Research division, Ground Floor, Room No. 17 and 18, Clinical Reserch Area, Unit -1 Vishakapatnam-530002, A.P, India
Visakhapatnam
ANDHRA PRADESH 
9440608752

amcorthopaedics@hotmail.com 
Dr Raja Pandian  Apollo Specialty Hospitals  Department of Orthopaedics, Room No. 65, Lake View Road, K. K. Nagar, Madurai – 625020, Tamil Nadu, India
Madurai
TAMIL NADU 
9965528552

panvind@yahoo.co.in 
Dr Rajesh Kumar Dulani  AVBR Hospital & Jawaharlal Nehru Medical College   Department of Orthopaedics, Datta Megha Instititute of Medical Sciences, Wardha, Nagpur -442004
Nagpur
MAHARASHTRA 
9371171000

rajeshkdulani@gmail.com 
Dr Ankit Balkrishna Kedia  BJ Medical College & Civil Hospital  B.J Medical College & Civil Hospital, Department of Orthopedics, Wing 2, Ground Floor, Ahmedabad-380016
Ahmadabad
GUJARAT 
9879371171

ankitk@gmail.com 
Dr Bartakke Girish Chandra Dyaneshwar  BJ medical college & Sassoon General Hospital  BJ Medical College Sassoon General Hospital, Dept of Orthopedics,Orthopedic Building, 2nd Floor, HOD Room, Sassoon Road, Near Railway Station, Pune - 411001
Pune
MAHARASHTRA 
9422036065

girishbartakke@rediffmail.com 
Dr D Raj Kiran  CARE Hospitals  Department of Orthopaedics, Road No. 01, Banjara Hills, Hyderabad- 500034 Andhra Pradesh
Hyderabad
ANDHRA PRADESH 
9849365340

docterrajkiran@gmail.com 
Dr Bharath Mody  Centre for Knee and Hip Surgery  Centre for Knee & Hip Surgery, Deaprtment of Orthopaedics, Clinical Research Division, 3rd Floor, Room No. 10, Clinical Research Department, 101/103, Akashganga Building, Near Vanijya Bhavan, Race Course Circle, Vadodara 390007, Gujarat, India Welcare Hospital, Nera Mile Motors, Atladara, Vadodara - 390012
Vadodara
GUJARAT 
0265-2353670

mail@centreforkneesurgery.com 
Dr Somesh Prakashbhai Singh  GMERS Medical College & Civil Hospital  Dept. of Orthopedics, Ground floor, Room No. 5, Sola, Near Gujarat High Court, S. G. Highway, Ahmedabad 380061, Gujarat.
Ahmadabad
GUJARAT 
9825370446

drsomeshsingh@yahoo.com 
Dr Samprassad S Nadkarni  Goa Medical College  Dept. Of Orthopedics, Faculty Block, Ground Floor, Goa Medical College, Bambolim, Tiswadi Goa-India, PO Box Bambolim.: 403202.
North Goa
GOA 
9822180392

sambnadkarni@yahoo.co.in 
Dr Ravindran  Government Medical College  Department of Orthopaedics, Ward No. 24, Kozhikode, Kerala 673008
Kozhikode
KERALA 
9447023525

raveendranmk@gmail.com 
Dr Sajal R Mitra  Government Medical College and Hospital  Government Medical College and Hospital, Dept of Orthopedics, OT-E, Opp. Ward No. 26, 1st Floor Nagpur
Nagpur
MAHARASHTRA 
9373114929

sajalmitra2007@yahoo.co.in 
Dr Narendra V Kothari  Hatkesh Healthcare Foundation  Hutkesh Healthcare Foundation, Deaprtment of Orthopaedics, Clinical Research Divison, 2st Floor, Research Room, Opp. Bhutnath Temple,Junagadh, 362001
Junagadh
GUJARAT 
912852654652

hatkesh.research@gmail.com 
Dr Alok Shobhan Datta  Institute of Post Graduate Medical Education and Research (IPGMER)  Department of Orthopedics, Ronald Ross Building, Ground Floor, # 244, AJC Bose Road, Kolkata 700020
Kolkata
WEST BENGAL 
9433718543

aloksobhondatta@gmail.com 
Dr Smruti Ramteke  Jasleen Hospital  Jasleen Hospital,Dept. of Orthopedics, Clinical Research Division, 1st Floor, Clinical Research Room, Opp. Big Bazar, Panchashil Square, wardha Road, Nagpur-440012
Nagpur
MAHARASHTRA 
9823514680

sramteke@rediffmail.com 
Dr Krishna Subrahmanya Kumar Pannala   Kamineni Hospitals  Department of orthopaedics, OPD room number 12, L. B. Nagar, Hyderabad-500068, Andhra Pradesh, India
Hyderabad
ANDHRA PRADESH 
9246277646

subri_pannala@yahoo.co.in 
Dr Surendra Umesh Kamath  Kasturba Medical College Hospital  Deaprtment of Orthopaedics, Ground Floor, OPD No. 12, Attavar, Mangalore – 575001, Karnataka, India
Dakshina Kannada
KARNATAKA 
9844275231

skamath3@hotmail.com 
Dr Ashok Kumar  King George Hospital  Department of Orthopedics, Unit - II, OP No. 10, King George Hospital, Andhra Medical College, Visakapatnam-530002
Visakhapatnam
ANDHRA PRADESH 
9849123602

Ashok_ortho59@rediffmail.com 
Dr Ashish Kumar  King George Medical University  Department of Orthopedic Surgery, Lal Bahadur Shastri Bhawan, 4th Floor, Lucknow 226018
Lucknow
UTTAR PRADESH 
9415020202

drashish_kumar20202@yahoo.com 
Dr Bhandankar  KLES Medical College  KLES Dr. Prabhakar Kore Hospital and Medical Research Center Dept. Of Joint Replacement and Anthroscopy, Nehru Nagar, Belgaum,Karnataka – 590010
Belgaum
KARNATAKA 
9844131106

rajendra.bhandankar@gmail.com 
Dr Veeravalli Sarath Chandra Mouli  Krishna Institute of Medical Sciences Ltd  Department of Orthopaedics, 1-8-31/1, Block 3, Room No. 1, Minister Road, Secunderabad- 500003
Hyderabad
ANDHRA PRADESH 
9866000685

sarath10@hotmail.com 
Prof Arvind Gore Gaonkar  Lokmanya Tilak Municipal Medical College & Lokmanya Tilak Municipal General Hospital   Lokmanya Tilak Municipal Medical College & Lokmanya Tilak Municipal General Hospital, Department of Orthopaedics, Department of Pharmacology, College Building, Second Floor, Room No. 2, Dr. B. R. Ambedkar Road, Sion, Mumbai - 400022
Mumbai
MAHARASHTRA 
9821351787

abgoregaonkar@gmail.com 
Dr Naresh Shetty  M. S. Ramaiah Medical College & Hospitals  Department of Orthopaedics, MSRIT Post, New BEL Road, Bangalore – 560054 Karnataka
Bangalore
KARNATAKA 
9844917728

naresh8@hotmail.com 
Dr Kunal Bhalla  M. V. Hospital and Research Centre  Deaprtment of Orthopaedics, 314/30, Ground Floor, OP No. 2, Mirza Mandir Chowk, Lucknow -226 003 Uttar Pradesh
Lucknow
UTTAR PRADESH 
9450903602

kunalicious_kunal@yahoo.com 
Dr Rajiv Gupta  Malpani Multispeciality Hospital  Malpani Multispeciality Hospital, Department of Orthopaedics,Clinical Research Division, Basement Clinical Research Facility, SP-6, Road No-1, V.K.l Area, Sikar Road, Jaipur-302013
Jaipur
RAJASTHAN 
9414980697

drrajivg77@gmail.com 
Dr Suresh kumar Kejriwal  Medical College & Hospital  Department of Orthopedics, Emergency building, ground floor, Room No. 6, College Street, Kolkata -700073
Kolkata
WEST BENGAL 
9830349698

dr_suresh01@yahoo.com 
Dr Marula Siddappa  Mysore medical college   K R Hospital, Mysore Medical College & Research Institute, Department of Orthopaedics, Mysore
Mysore
KARNATAKA 
9844319497

gmsortho@gmail.com 
Dr Sushil H Mankar  NKP salve Institute of Medical Sciences and Lata Mangeshkar Hospital  Deaprtment of Orthopaedics, 1st Floor, Digdoh Hills, Hingna road, Nagpur, Maharashtra-India
Nagpur
MAHARASHTRA 
9422108284

drshmankar@rediffmail.com 
Dr Vijay Goni  Post Graduate Institute of Medical Institute of Medical Education and Research (PGIMER)  Post Graduate Institute of Medical Education & Research (PGIMER), Dept. of Orthopedics, Ground Floor, Chandigarh-160012 , India
Chandigarh
CHANDIGARH 
9815712727

vijaygoni@gmail.com 
Dr Gaurav Jugalkishore Rathi  Rathi Hospital  Rathi Hospital, Department of Orthopaedics, Clinical Reasearch Division, Basement Clinical Research Area, Nr Anupam Shopping Centre, Opp Mahabaleshwar Soc, Nr Jodhpur Cross roads, Satellite, Ahmedabad 280 015, Gujarat, India
Ahmadabad
GUJARAT 
9824015618

drgjrathi@yahoo.co.in 
Dr Sandip Roy  RG Kar Medical College  RG Kar Medical College & Hospital,Deaprtment of Orthopaedics, Outdoor Building, Room No. 106, 1, Kshudiram Bose Sarani, Kolkatta – 700001
Kolkata
WEST BENGAL 
9830048261

drskroy@hotmail.com 
Dr Parag Sancheti  Sancheti Institute for Orthopaedics and Rehabilitation  Sancheti Institue for Orthopaedics and Rehabilitation, Dept. of Orthopedics, Clinical Research Division, 1st Floor, Sancheti Research Department, 16 Shivaji Nagar, Pune - 411005. Maharashtra
Pune
MAHARASHTRA 
9822353333

parag@sanchetihospital.org 
Dr Harshal Kalariya  Shree Giriraj Multispecilaity Hospital  Shree Giriraj Multispeciality Hospital, Dept. of Orthopedics, Clinical Research Division, Basement Clinical Research Facility, 150 Feet Ring Road, 27-Navjyot Park Main Road, Amin Marg Cross Road, Rajkot, Gujarat 360005
Rajkot
GUJARAT 
9979883331

harshalkalaria@gmail.com 
Dr Neel Bhavsar  Smt NHL Municipal Medical College  Smt NHL Municipal Medical College, Department of Orthopaedics, Ortho OPD Building, Unit-A, Near Trauma Centre, Room No. 42, Ellisbridge, Ahmedabad-380006
Ahmadabad
GUJARAT 
9638040954

neelmb@yahoo.com 
Dr Joe Joseph Cherian  St. Johns Medical College Hospital  Department of Orthopedics, 3rd Floor, Sarjapur Road, Koramangala,Banglore-560034
Bangalore
KARNATAKA 
9343794300

cherianjoe71@gmail.com 
Dr Gurava Reddy   Sunshine hospital   Sunshine Hospitals, Department of Orthopaedics, Room No. 3, P.G. Road, Paradise, Secunderabad – 500003
Hyderabad
ANDHRA PRADESH 
040-44550000

guravareddy@gmail.com 
 
Details of Ethics Committee
Modification(s)  
No of Ethics Committees= 35  
Name of Committee  Approval Status 
B.J.Medical College Ethics Committee  Approved 
Ethics Committee Centre for Knee Surgery (ECCKS)  Approved 
Ethics committee, Apollo Specialty Hospitals  Approved 
Ethics committee, KLE University  Submittted/Under Review 
Ethics committee, M. S. Ramaiah Medical College & Hospitals   Approved 
Hatkesh Healthcare Foundation Ethics Committee  Approved 
Institutional Ethics Committee - Krishna Institute of Medical Sciences Ltd.  Submittted/Under Review 
Institutional Ethics Committee - Malpani Multispeciality Hospital   Approved 
Institutional Ethical Review Board, St. Johns Medical College Hospital  Approved 
Institutional ethics committee & Human Resource LTMMC & GH Staff and Research Society  Approved 
Institutional ethics committee (IEC) M. V. Hospital and Research Centre  Approved 
Institutional ethics committee BJ Medical College & Civil Hospital  Approved 
Institutional ethics committee for Human Research, Medical College  Submittted/Under Review 
Institutional ethics committee GMERS Medical College  Approved 
Institutional ethics committee Goa Medical College  Approved 
Institutional ethics committee of King George Hospital  Approved 
Institutional ethics committee of King George Medical University  Submittted/Under Review 
Institutional ethics committee, Andhra Medical college, Vishakapatnam-530002, A.P - India  Approved 
Institutional ethics committee, CARE Convergence centre   Submittted/Under Review 
Institutional ethics committee, DMIMS (DU) Sawangi (Meghe) Wardha  Submittted/Under Review 
Institutional ethics committee, Government Medical College and Hospital, Nagpur  Approved 
Institutional ethics committee, Govt. medical college , Kozikhode  Approved 
Institutional ethics committee, Institute of Post Graduate Medical Education and Research   Approved 
Institutional ethics committee, Kamineni Hospitals Pvt Ltd  Approved 
Institutional ethics committee, Mysore Medical College & Research Institute   Approved 
Institutional ethics committee, NKP salve Institute of Medical Sciences  Approved 
Institutional ethics committee, PGIMER, Chandigarh-160012, India  Submittted/Under Review 
Institutional ethics committee, RG Kar Medical College  Submittted/Under Review 
Institutional ethics committee, Smt NHL Municipal Medical College  Submittted/Under Review 
Institutional ethics committee, Sunshine hospital  Approved 
Jasleen Hospitals Ethics Committee  Approved 
Manipal University Ethics Committee  Approved 
Rathi Ethics Committee  Approved 
Sancheti Institute for Orthopaedics and Rehabilitation Institutional Review Board  Approved 
Shree Giriraj Hospital Research Ethics Committee  Approved 
 
Regulatory Clearance Status from DCGI  
Status 
Approved/Obtained 
 
Health Condition / Problems Studied  
Health Type  Condition 
Patients  Patients with osteoarthritis of the knee ,  
 
Intervention / Comparator Agent  
Type  Name  Details 
Comparator Agent  1% Voltaren® Gel  Voltaren® Gel is a nonsteroidal anti-inflammatory drug indicated for the relief of the pain of osteoarthritis of joints amenable to topical treatment, such as the knees and those of the hands.Each patient will apply 1 dose of 4 gram for 4 times a day for 28 days 
Intervention  Generic Diclofenac Sodium Topical Gel   It is a nonsteroidal anti-inflammatory drug indicated for the relief of the pain of osteoarthritis of joints amenable to topical treatment, such as the knees and those of the hands. (Therapeutic Equivalence Study.Each patient will apply 1 dose of 4 gram for 4 times a day for 28 days  
Intervention  Vehicle (Placebo)  Vehicle (Placebo) of Diclofenac Sodium Topical Gel, 1%. Each patient will apply 1 dose of 4 gram for 4 times a day for 28 days 
 
Inclusion Criteria  
Age From  35.00 Year(s)
Age To  75.00 Year(s)
Gender  Both 
Details  1.Evidence of a signed and dated informed consent document(s) indicating that the subject has been informed of all pertinent aspects of the study.
2.Healthy, ambulatory male or non-pregnant female subjects aged ≥ 35 years with a clinical diagnosis of OA of the knee including:
•Presence of at least three (3) of the American College of Rheumatology (ACR) criteria (age ≥ 50; stiffness lasting < 30 mins; bony tenderness; crepitus; bony enlargement; no palpable warmth)
•Symptoms for at least 6 months prior to screening, AND
•Knee (not referred) pain for 15 days of the preceding month (periarticular knee pain due to OA and not due to other conditions such as bursitis, tendonitis, etc.), AND
•The pain in the target knee required the use of NSAIDs or paracetamol/ acetaminophen (topical or oral treatments).
3.Had an X-ray of the target knee, taken no more than 1 year before baseline, showing evidence of OA with Kellgren-Lawrence grade 1-3 disease.
4.After discontinuing all pain medications for at least 7 days, has at least moderate pain on movement (POM) for target knee, defined as a baseline score of ≥ 50 mm on a 0-100 mm Visual Analog Scale (VAS) immediately prior to randomization, AND a baseline Western Ontario McMaster Osteoarthritis (WOMAC) pain subscale of at least 9 immediately prior to randomization.
5.If female and of child-bearing potential, agree to abstain from sexual intercourse or use a reliable method of contraception during the study (e.g., condom + spermicide, IUD, oral, transdermal, injected or implanted hormonal contraceptives).
6.Able to tolerate rescue medication with paracetamol/acetaminophen.
7.Willing and able to comply with the study requirements.
 
 
ExclusionCriteria 
Details  1.Pregnant or lactating or planning to become pregnant during the study period.
2.X-ray showing evidence of OA with Kellgren-Lawrence grade 4 disease.
3.History of OA pain in the contralateral knee requiring medication (OTC or prescription) within 1 year prior to screening.
4.After discontinuing all pain medications for at least 7 days, has a baseline score of ≥ 20 mm on a 0-100 mm Visual Analog Scale (VAS) for the contralateral knee immediately prior to randomization.
5.History of secondary OA, rheumatoid arthritis, chronic inflammatory disease (e.g., colitis) or fibromyalgia.
6.History of asthma, hypertension, myocardial infarction, thrombotic events, stroke, congestive heart failure, impaired renal function or liver disease.
7.History of gastrointestinal bleeding or peptic ulcer disease.
8.Use of warfarin or other anticoagulant therapy within 30 days of study randomization.
9.Elevated transaminases at screening (AST or ALT more than 2 times the upper limit of normal at screening visit).
10.Use of ACE-inhibitors, cyclosporine, diuretics, lithium, or methotrexate within 30 days of study randomization.
11.Concomitant use of corticosteroids (any formulation) or use within 30 days of study randomization.
12.Concomitant acetylsalicylic acid therapy other than a stable low dose used for cardiac prophylaxis (max 162 mg daily) taken for at least 3 months prior to enrollment and maintained throughout the duration of the study.
13.Known allergy to aspirin or nonsteroidal anti-inflammatory drug (NSAID).
14.Any other acute or chronic illness that in the opinion of the investigator could compromise the integrity of study data or place the subject at risk by participating in the study.
15.Receipt of any drug as part of a research study within 30 days prior to screening.
16.Previous participation in this study.
17.Any use between screening and baseline of a treatment or medication that may potentially confound study assessment (e.g. use of topical analgesics or anti-inflammatory drugs).
18.Recent history of major knee injury or surgery.
19.Known history of positive HIV.
 
 
Method of Generating Random Sequence   Computer generated randomization 
Method of Concealment   Other 
Blinding/Masking   Outcome Assessor Blinded 
Primary Outcome  
Outcome  TimePoints 
The primary efficacy endpoint will be the mean change from baseline to week 4 in the WOMAC pain score   Assessment of WOMAC scale from Day 1 to Day 28 
 
Secondary Outcome  
Outcome  TimePoints 
not applicable  not applicable 
 
Target Sample Size   Total Sample Size="1176"
Sample Size from India="1176" 
Final Enrollment numbers achieved (Total)= "Applicable only for Completed/Terminated trials"
Final Enrollment numbers achieved (India)="Applicable only for Completed/Terminated trials" 
Phase of Trial   Phase 3 
Date of First Enrollment (India)   24/03/2014 
Date of Study Completion (India) Applicable only for Completed/Terminated trials 
Date of First Enrollment (Global)  Date Missing 
Date of Study Completion (Global) Applicable only for Completed/Terminated trials 
Estimated Duration of Trial   Years="1"
Months="0"
Days="0" 
Recruitment Status of Trial (Global)
Modification(s)  
Not Applicable 
Recruitment Status of Trial (India)  Closed to Recruitment of Participants 
Publication Details   Not Applicable 
Individual Participant Data (IPD) Sharing Statement

Will individual participant data (IPD) be shared publicly (including data dictionaries)?  

Brief Summary   This will be randomized, multi-center, double blind, vehicle controlled, parallel group study to be performed at approximately 35 study sites located in India. The randomized subjects will be enrolled in a 1:1:1 ratio.The primary efficacy end point in the study is the mean change from baseline to week 4 in the WOMAC pain score (pain score= 0 to 20), which will be determined by the subjects responses to five questions (S1-S5) using a 5-point likert scale (i.e., none=0, mild=1, moderate=2, serve=3, extreme=4). The questions pertain to the amount of pain the subject is currently experiencing in the target knee [i.e., How much pain do you have when walking on a flat surface (S1), Going up or down stairs (S2), At night while in bed (S3), Sitting or lying (S4), Standing upright (S5)] 
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