PB125, Osteoarthritis, Pain, Mobility, and Energetics

Sponsor
Colorado State University (Other)
Overall Status
Recruiting
CT.gov ID
NCT04638387
Collaborator
(none)
10
1
2
18.9
0.5

Study Details

Study Description

Brief Summary

Nuclear factor erythroid 2-related factor 2 (Nrf2) is an important regulator in the body. It controls how well cells protect themselves against stress. PB125 (Pathways Bioscience) is a plant based activator of this important regulator Nrf2. PB125 is made up of three plant extracts (rosemary, ashwagandha, and Sophora japonica) so that it contains these things; 1. Carnosol, 2. Withaferin A, and 3. Luteolin. Carnosol comes from rosemary leaves. Rosemary is a spice often used in Italian foods and grown in many herb gardens all around Fort Collins. Withaferin A comes from the medicinal plant Withania somnifera, also called ashwagandha. Ashwaganda is commonly known as "Indian Winter cherry" or "Indian Ginseng" and it is one of the most important herbs of Ayurveda (the traditional system of medicine in India) used for millennia. Finally, luteolin is found widely in plants including those present in the diet (peppers, onions, celery, herbs/spices). Some people purchase these herbs commercially, and take them on their own for a variety of purposes. Typically, when you buy them, they will be in much higher doses than they are in PB125. What makes PB125 different is that very low doses of each of the 3 components work together-synergistically-to activate Nrf2 and increase the ability of cells to respond to stress. It is unknown if there are any benefits to taking PB125 and the risks are currently unknown. The purpose of this study is to examine changes in muscle, in joint pain, in mobility (standing and walking) and in leg strength that occur after consuming PB125 every day for 3 months. We want to make these measurements in people who have been diagnosed with mild to moderate osteoarthritis-a degenerative joint disease-in their knees.

Condition or Disease Intervention/Treatment Phase
  • Dietary Supplement: PB125
  • Dietary Supplement: Placebo
N/A

Detailed Description

Preventing or slowing age-related decline in musculoskeletal function is important for maintaining mobility and independence. In the US, osteoarthritis (OA) is the primary cause of disability in adults, with no medical or surgical therapeutic intervention known to restore the degenerated cartilage. The loss of skeletal muscle mass and function with age, is also linked to increased risk of other diseases, risk of falls, and decreased quality of life. Therefore, OA and muscle loss together are primary contributors to age-related decreases in mobility and independence. Evidence suggests a decrease in muscle quality is associated with or precedes primary knee OA, suggesting that these two conditions may share a common cause. We will treat 50-65 year old people with mild or moderate OA in both knees, and reported loss of muscle strength, with a supplement already available for use in humans to reduce oxidative stress and inflammation. The supplement is called PB125. In this pilot clinical trial, we will measure the ability of muscle to make energy, measure mobility (walking and standing) and strength, and assess pain following PB125 or placebo treatment.

Study Design

Study Type:
Interventional
Anticipated Enrollment :
10 participants
Allocation:
Non-Randomized
Intervention Model:
Single Group Assignment
Intervention Model Description:
Primary comparisons will be between pre-test and post-test measures. We had initially planned control group comparisons as well, but the pandemic has cut this pilot study short of budget and time. Therefore, the primary comparisons will now be pre-test to post-test to maximize the number of participants enrolled to receive the experimental treatment.Primary comparisons will be between pre-test and post-test measures. We had initially planned control group comparisons as well, but the pandemic has cut this pilot study short of budget and time. Therefore, the primary comparisons will now be pre-test to post-test to maximize the number of participants enrolled to receive the experimental treatment.
Masking:
Double (Participant, Outcomes Assessor)
Masking Description:
Participants will not know if they are receiving PB125 or placebo. Participants will complete pain surveys. Team members making measurements of mobility and mitochondrial energetics will not know if participants or samples are PB125 or placebo.
Primary Purpose:
Treatment
Official Title:
Nuclear Factor Erythroid 2-Related Factor 2 (Nrf2) Activation, Mobility, and Energetics: A Pilot and Feasibility Clinical Trial of PB125 Treatment for Improving Musculoskeletal and Pain Outcomes in Osteoarthritis
Actual Study Start Date :
Nov 3, 2020
Anticipated Primary Completion Date :
Nov 1, 2021
Anticipated Study Completion Date :
Jun 1, 2022

Arms and Interventions

Arm Intervention/Treatment
Experimental: PB125

Twice daily oral administration of 1 capsule of PB125 (Pathways Bioscience). Treatment will last 12 weeks.

Dietary Supplement: PB125
Nrf2 activator containing active ingredients carnosol, withaferin A, and luteolin.

Placebo Comparator: Placebo

Twice daily oral administration of 1 capsule of rice flour placebo (Pathways Bioscience). Treatment will last 12 weeks. Because of pandemic restricting study time frame, enrollment will favor the experimental arm in this pilot study

Dietary Supplement: Placebo
Placebo comparator to P125
Other Names:
  • Flour
  • Outcome Measures

    Primary Outcome Measures

    1. Mobility-6 min self-paced walk [Change from baseline at 12 weeks]

      Change in Distance walked

    2. Mobility-sit to stand [Change from baseline at 12 weeks]

      Change in Time for 5 sit to stand repetitions

    3. Mobility-static balance [Change from baseline at 12 weeks]

      Yes/No ability to complete 30 sec trials with eyes open or closed on firm and foam surfaces

    4. Mobility-6 min fast-paced walk [Change from baseline at 12 weeks]

      Change in Distance walked

    5. Intermittent and Constant Knee Pain [Change weekly for 12 weeks]

      Weekly change in Intermittent and Constant Pain Score (ICOAP) 11 question survey of pain on a 0-4 scale

    6. Energetics-Submaximal Oxygen Consumption [Change from baseline at 12 weeks]

      Change in oxygen (O2) flux in permeabilized muscle fibers at submaximal adenosine diphosphate (ADP) concentrations

    7. Energetics-Maximal Oxygen Consumption [Change from baseline at 12 weeks]

      Change in O2 flux in permeabilized muscle fibers at maximal ADP concentrations

    Secondary Outcome Measures

    1. Energetics-hydrogen peroxide emission [Change from baseline at 12 weeks]

      Change in Hydrogen peroxide emission in permeabilized muscle fibers

    2. Bone Mineral Density [Change from baseline at 12 weeks]

      Bone mineral density via dual x-ray absorptiometry (DEXA)

    3. Knee Range of Motion [Change from baseline at 12 weeks]

      Change in active and passive bilateral knee range of motion

    4. Leg extensor strength [Change from baseline at 12 weeks]

      Change in maximal force generated during knee extension

    Eligibility Criteria

    Criteria

    Ages Eligible for Study:
    50 Years to 65 Years
    Sexes Eligible for Study:
    All
    Accepts Healthy Volunteers:
    No
    Inclusion Criteria:
    • bilateral knee osteoarthritis
    Exclusion Criteria:
    • smoking

    • pregnant/breastfeeding

    • BMI >30

    • known liver, renal, heart disease, diabetes, autoimmune disease, cancer

    • use of methotrexate, etanercept, infliximab, leflunomide, plaquenil

    • recent serious illness

    • intraarticular stem cell injection

    • intraarticular steroid or hyaluronic acid injection within 4 months

    • current enrollment in another trial of investigational drugs

    • known hypersensitivity to ashwagandha, luteolin, rosemary, or rice flour

    • use of anticoagulants or known bleeding disorder

    • unwillingness to comply with protocol

    • plans for knee replacement in the next 3 years

    • unable to complete mobility testing without ambulatory aid

    • unable to climb 1-2 flights or stairs without stopping/shortness of breath/discomfort

    • blood product transfusion within 30 days

    • unable to provide legal consent

    Contacts and Locations

    Locations

    Site City State Country Postal Code
    1 Colorado State University Fort Collins Colorado United States 80523-1582

    Sponsors and Collaborators

    • Colorado State University

    Investigators

    None specified.

    Study Documents (Full-Text)

    None provided.

    More Information

    Additional Information:

    Publications

    None provided.
    Responsible Party:
    Karyn Hamilton, Professor, Colorado State University
    ClinicalTrials.gov Identifier:
    NCT04638387
    Other Study ID Numbers:
    • 19-9100H
    First Posted:
    Nov 20, 2020
    Last Update Posted:
    Nov 20, 2020
    Last Verified:
    Nov 1, 2020
    Studies a U.S. FDA-regulated Drug Product:
    No
    Studies a U.S. FDA-regulated Device Product:
    No
    Additional relevant MeSH terms:

    Study Results

    No Results Posted as of Nov 20, 2020