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Allopurinol Combination Study (RDEA594-203)

Primary Purpose

Gout

Status
Completed
Phase
Phase 2
Locations
International
Study Type
Interventional
Intervention
RDEA594
Placebo
Allopurinol
Sponsored by
Ardea Biosciences, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gout

Eligibility Criteria

18 Years - 80 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or a post-menopausal or surgically sterile female.
  2. 18 - 80 years of age.
  3. Has been taking allopurinol as the sole urate lowering therapy for hyperuricemia for at least 6 weeks at a dose between 200 mg and 600 mg per day without an adequate response.
  4. Has a sUA level ≥ 6 mg/dL at screening.
  5. Meets criteria for the diagnosis of gout as per the American Rheumatism Association (ARA) Criteria for the Classification of Acute Arthritis of Primary Gout.
  6. Willing and able to give informed consent and adhere to visit/protocol schedules (informed consent must be given before the first study procedure is performed).
  7. Subjects entering the optional Extension Period must have completed 28 days of dosing in the Double-Blind Treatment Period and the Day 42 Visit in the Follow-up Period within 4 months and must not have experienced any serious adverse events considered possibly related to study drug.
  8. Subjects entering the optional Open-Label Extension Period must continue to be compliant with the protocol through Week 44 of the Double-Blind Extension Period and must not have experienced any serious adverse events considered possibly related to study drug.

Exclusion Criteria:

  1. Consumes more than 14 drinks of alcohol per week (e.g., 1 drink = 5 oz [150 ml] of wine, 12 oz [360 ml] of beer, or 1.5 oz [45 ml] of hard liquor).
  2. History or suspicion of drug abuse.
  3. History of documented or suspected kidney stones.
  4. Has rheumatoid arthritis or other autoimmune disease requiring treatment.
  5. Documented or suspicion of HIV infection.
  6. Positive serology to HCV antibodies (Abs), and/or hepatitis B surface antigen (HBsAg).
  7. History of malignancy within 5 years prior to the first dose of study medication, other than non-melanomatous skin cancer or cervical dysplasia.
  8. History of cardiac abnormalities, including abnormal and clinically relevant ECG changes
  9. Any condition predisposing to QT prolongation including pathological Q-wave (defined as Q-wave >40 msec or depth > 0.4-0.5 mV).
  10. Any use of concomitant medications that prolong the QT/QTc interval within the 14 days prior to Baseline (Day 1).
  11. QT interval corrected for heart rate according to Fridericia (QTcF) > 450 msec at Screening or pre-dose at Baseline (Day 1).
  12. Uncontrolled hypertension (above 150/95).
  13. Inadequate renal function [serum creatinine >1.5 mg/dL or creatinine clearance < 60 mL/min (by Cockroft-Gault formula)].
  14. Hemoglobin < 10 g/dL (males) or < 9 g/dL (females).
  15. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 x upper limit of normal (ULN).
  16. Gamma glutamyl transferase (GGT) > 3 x ULN.
  17. Active peptic ulcer disease requiring treatment.
  18. History of xanthinuria, active liver disease, or hepatic dysfunction.
  19. Requires therapy with any other urate-lowering medication, other than the study medications.
  20. Requires long-term use of salicylates; diuretics; losartan; azathioprine; mercaptopurine; theophylline; intravenous colchicine; cyclosporine; cyclophosphamide; pyrazinamide; sulfamethoxazole; or trimethoprim.
  21. Taking medications known as enzyme inducers (see section 3.7 for listing).
  22. Reports receiving a strong or moderate inhibitor of CYP3A4 or a P-gp inhibitor within 1 month prior to study drug dosing, due to potential interactions with colchicine.
  23. Acute gout flare (exclusive of chronic synovitis/ arthritis) during the Screening-Period that has not resolved one week prior to the Baseline Visit (Day 0).
  24. Pregnant or breast feeding.
  25. Has received an investigational medication within 4 weeks prior to the screening visit for this study.
  26. Previously participated in a clinical study involving RDEA806 or RDEA594.
  27. Known hypersensitivity or allergy to RDEA594, allopurinol or colchicine or any components in their formulations.
  28. Body mass index (BMI) >48 kg/m2.
  29. Taking greater than 1000 mg/day of Vitamin C.
  30. Any other medical or psychological condition, which in the opinion of the Investigator and/or Medical Monitor, might create undue risk to the subject or interfere with the subject's ability to comply with the protocol requirements, or to complete the study.
  31. Inadequate renal function after completing the Double-Blind Treatment period prior to entering Double-Blind Extension Period.
  32. Requiring treatment with prohibited medications noted in exclusion criteria numbers 20-23 after completing the Double-Blind Treatment Period prior to entering the Extension Period.
  33. Clinically relevant medical event as determined by the investigator in consultation with medical monitor prior to entering the Extension Period.

Sites / Locations

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Placebo Comparator

Experimental

Arm Label

RDEA594 200 mg qd

RDEA594 200 mg, 400 mg qd

Matching Placebo

RDEA594 600 mg qd

Arm Description

RDEA594 200 mg qd plus allopurinol qd

RDEA594 200 mg then 400 mg qd plus allopurinol qd. Patients on lesinurad 400 mg had their dose changed to lesinurad 200 mg after protocol amendment 16 dated 07 October 2015.

RDEA594 matching placebo qd plus allopurinol qd, then allopurinol qd alone in open label period. Patients on allopurinol qd alone were discontinued after protocol amendment 16 dated 07 October 2015.

RDEA594 200 mg then 400 mg then 600 mg plus allopurinol qd Patients on lesinurad 600 mg had their dose changed to lesinurad 200 mg after protocol amendment 16 dated 07 October 2015.

Outcomes

Primary Outcome Measures

To compare the percent reduction from baseline in serum urate levels following 4 wks of continuous treatment of RDEA594 in combination with allopurinol to allopurinol alone in subjects with documented inadequate hypouricemic response.

Secondary Outcome Measures

To evaluate the proportion of subjects whose sUA levels are < 6.0 mg/dL, < 5.0 mg/dL and < 4.0 mg/dL at each study visit by treatment group in all subjects and in subjects who have an sUA ≥6 mg/dL at the baseline visit.
To evaluate the absolute and percent reduction from baseline in sUA levels at each visit.
To evaluate the percentage change in 24-hour urine urate level (excretion) from baseline to Day 28.
To evaluate the incidence of gout flares.
To evaluate the safety and tolerability of RDEA594 in combination with allopurinol in subjects with gout.
To compare the multiple-dose pharmacokinetics (PK) of allopurinol and oxypurinol in the absence versus presence of RDEA594 co-administration.
To evaluate the proportion of subjects whose sUA level decreases to or is maintained at <6.0 mg/dL and <5.0 mg/dL in the Double-Blind and Open-Label Extension Period.

Full Information

First Posted
October 22, 2009
Last Updated
January 23, 2017
Sponsor
Ardea Biosciences, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT01001338
Brief Title
Allopurinol Combination Study
Acronym
RDEA594-203
Official Title
Randomized, Double-Blind, Multicenter, Placebo-Controlled, Combination Study to Evaluate the Safety, Efficacy and Potential Pharmacokinetic Interaction of RDEA594 and Allopurinol in Gout Patients With an Inadequate Hypouricemic Response With Standard Doses of Allopurinol
Study Type
Interventional

2. Study Status

Record Verification Date
January 2017
Overall Recruitment Status
Completed
Study Start Date
October 2009 (undefined)
Primary Completion Date
January 2011 (Actual)
Study Completion Date
August 2016 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ardea Biosciences, Inc.

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
To compare the proportion of subjects whose serum urate (sUA) levels are < 6.0 mg/dL following 4 weeks of continuous treatment of RDEA594 in combination with allopurinol to allopurinol alone in subjects with documented inadequate hypouricemic response with standard doses of allopurinol.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Gout

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Factorial Assignment
Masking
ParticipantCare ProviderInvestigator
Allocation
Randomized
Enrollment
227 (Actual)

8. Arms, Groups, and Interventions

Arm Title
RDEA594 200 mg qd
Arm Type
Experimental
Arm Description
RDEA594 200 mg qd plus allopurinol qd
Arm Title
RDEA594 200 mg, 400 mg qd
Arm Type
Experimental
Arm Description
RDEA594 200 mg then 400 mg qd plus allopurinol qd. Patients on lesinurad 400 mg had their dose changed to lesinurad 200 mg after protocol amendment 16 dated 07 October 2015.
Arm Title
Matching Placebo
Arm Type
Placebo Comparator
Arm Description
RDEA594 matching placebo qd plus allopurinol qd, then allopurinol qd alone in open label period. Patients on allopurinol qd alone were discontinued after protocol amendment 16 dated 07 October 2015.
Arm Title
RDEA594 600 mg qd
Arm Type
Experimental
Arm Description
RDEA594 200 mg then 400 mg then 600 mg plus allopurinol qd Patients on lesinurad 600 mg had their dose changed to lesinurad 200 mg after protocol amendment 16 dated 07 October 2015.
Intervention Type
Drug
Intervention Name(s)
RDEA594
Intervention Description
Uricosuric agent for the treatment of gout.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Matching Placebo
Intervention Type
Drug
Intervention Name(s)
Allopurinol
Intervention Description
Allopurinol
Primary Outcome Measure Information:
Title
To compare the percent reduction from baseline in serum urate levels following 4 wks of continuous treatment of RDEA594 in combination with allopurinol to allopurinol alone in subjects with documented inadequate hypouricemic response.
Time Frame
28 days
Secondary Outcome Measure Information:
Title
To evaluate the proportion of subjects whose sUA levels are < 6.0 mg/dL, < 5.0 mg/dL and < 4.0 mg/dL at each study visit by treatment group in all subjects and in subjects who have an sUA ≥6 mg/dL at the baseline visit.
Time Frame
28 days and through extension
Title
To evaluate the absolute and percent reduction from baseline in sUA levels at each visit.
Time Frame
28 days and through extension
Title
To evaluate the percentage change in 24-hour urine urate level (excretion) from baseline to Day 28.
Time Frame
28 days and through extension
Title
To evaluate the incidence of gout flares.
Time Frame
28 days and through extension
Title
To evaluate the safety and tolerability of RDEA594 in combination with allopurinol in subjects with gout.
Time Frame
28 days and through extension
Title
To compare the multiple-dose pharmacokinetics (PK) of allopurinol and oxypurinol in the absence versus presence of RDEA594 co-administration.
Time Frame
28 days
Title
To evaluate the proportion of subjects whose sUA level decreases to or is maintained at <6.0 mg/dL and <5.0 mg/dL in the Double-Blind and Open-Label Extension Period.
Time Frame
3 years

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
80 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or a post-menopausal or surgically sterile female. 18 - 80 years of age. Has been taking allopurinol as the sole urate lowering therapy for hyperuricemia for at least 6 weeks at a dose between 200 mg and 600 mg per day without an adequate response. Has a sUA level ≥ 6 mg/dL at screening. Meets criteria for the diagnosis of gout as per the American Rheumatism Association (ARA) Criteria for the Classification of Acute Arthritis of Primary Gout. Willing and able to give informed consent and adhere to visit/protocol schedules (informed consent must be given before the first study procedure is performed). Subjects entering the optional Extension Period must have completed 28 days of dosing in the Double-Blind Treatment Period and the Day 42 Visit in the Follow-up Period within 4 months and must not have experienced any serious adverse events considered possibly related to study drug. Subjects entering the optional Open-Label Extension Period must continue to be compliant with the protocol through Week 44 of the Double-Blind Extension Period and must not have experienced any serious adverse events considered possibly related to study drug. Exclusion Criteria: Consumes more than 14 drinks of alcohol per week (e.g., 1 drink = 5 oz [150 ml] of wine, 12 oz [360 ml] of beer, or 1.5 oz [45 ml] of hard liquor). History or suspicion of drug abuse. History of documented or suspected kidney stones. Has rheumatoid arthritis or other autoimmune disease requiring treatment. Documented or suspicion of HIV infection. Positive serology to HCV antibodies (Abs), and/or hepatitis B surface antigen (HBsAg). History of malignancy within 5 years prior to the first dose of study medication, other than non-melanomatous skin cancer or cervical dysplasia. History of cardiac abnormalities, including abnormal and clinically relevant ECG changes Any condition predisposing to QT prolongation including pathological Q-wave (defined as Q-wave >40 msec or depth > 0.4-0.5 mV). Any use of concomitant medications that prolong the QT/QTc interval within the 14 days prior to Baseline (Day 1). QT interval corrected for heart rate according to Fridericia (QTcF) > 450 msec at Screening or pre-dose at Baseline (Day 1). Uncontrolled hypertension (above 150/95). Inadequate renal function [serum creatinine >1.5 mg/dL or creatinine clearance < 60 mL/min (by Cockroft-Gault formula)]. Hemoglobin < 10 g/dL (males) or < 9 g/dL (females). Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) > 2.5 x upper limit of normal (ULN). Gamma glutamyl transferase (GGT) > 3 x ULN. Active peptic ulcer disease requiring treatment. History of xanthinuria, active liver disease, or hepatic dysfunction. Requires therapy with any other urate-lowering medication, other than the study medications. Requires long-term use of salicylates; diuretics; losartan; azathioprine; mercaptopurine; theophylline; intravenous colchicine; cyclosporine; cyclophosphamide; pyrazinamide; sulfamethoxazole; or trimethoprim. Taking medications known as enzyme inducers (see section 3.7 for listing). Reports receiving a strong or moderate inhibitor of CYP3A4 or a P-gp inhibitor within 1 month prior to study drug dosing, due to potential interactions with colchicine. Acute gout flare (exclusive of chronic synovitis/ arthritis) during the Screening-Period that has not resolved one week prior to the Baseline Visit (Day 0). Pregnant or breast feeding. Has received an investigational medication within 4 weeks prior to the screening visit for this study. Previously participated in a clinical study involving RDEA806 or RDEA594. Known hypersensitivity or allergy to RDEA594, allopurinol or colchicine or any components in their formulations. Body mass index (BMI) >48 kg/m2. Taking greater than 1000 mg/day of Vitamin C. Any other medical or psychological condition, which in the opinion of the Investigator and/or Medical Monitor, might create undue risk to the subject or interfere with the subject's ability to comply with the protocol requirements, or to complete the study. Inadequate renal function after completing the Double-Blind Treatment period prior to entering Double-Blind Extension Period. Requiring treatment with prohibited medications noted in exclusion criteria numbers 20-23 after completing the Double-Blind Treatment Period prior to entering the Extension Period. Clinically relevant medical event as determined by the investigator in consultation with medical monitor prior to entering the Extension Period.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Nihar Bhakta, MD
Organizational Affiliation
Ardea Biosciences, Inc.
Official's Role
Study Director
Facility Information:
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85050
Country
United States
City
La Jolla
State/Province
California
ZIP/Postal Code
92037
Country
United States
City
Los Angeles
State/Province
California
ZIP/Postal Code
90017
Country
United States
City
Stanford
State/Province
California
ZIP/Postal Code
94305
Country
United States
City
Boca Raton
State/Province
Florida
ZIP/Postal Code
33432
Country
United States
City
DeLand
State/Province
Florida
ZIP/Postal Code
32720
Country
United States
City
Fort Lauderdale
State/Province
Florida
ZIP/Postal Code
33334
Country
United States
City
Jupiter
State/Province
Florida
ZIP/Postal Code
33458
Country
United States
City
Meridan
State/Province
Idaho
ZIP/Postal Code
83642
Country
United States
City
Lexington
State/Province
Kentucky
ZIP/Postal Code
40504
Country
United States
City
Wheaton
State/Province
Maryland
ZIP/Postal Code
20902
Country
United States
City
Las Vegas
State/Province
Nevada
ZIP/Postal Code
89183
Country
United States
City
Reno
State/Province
Nevada
ZIP/Postal Code
89502
Country
United States
City
Harrisburg
State/Province
North Carolina
ZIP/Postal Code
28075
Country
United States
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
City
Cleveland
State/Province
Ohio
ZIP/Postal Code
44122
Country
United States
City
Mayfield Village
State/Province
Ohio
ZIP/Postal Code
44143
Country
United States
City
Durham
State/Province
South Carolina
ZIP/Postal Code
27710
Country
United States
City
Rock Hill
State/Province
South Carolina
ZIP/Postal Code
29732
Country
United States
City
Germantown
State/Province
Tennessee
ZIP/Postal Code
38138
Country
United States
City
Jackson
State/Province
Tennessee
ZIP/Postal Code
38305
Country
United States
City
Dallas
State/Province
Texas
ZIP/Postal Code
75231
Country
United States
City
San Antonio
State/Province
Texas
ZIP/Postal Code
78221
Country
United States
City
West Jordan
State/Province
Utah
ZIP/Postal Code
84088
Country
United States
City
Chesapeake
State/Province
Virginia
ZIP/Postal Code
23320
Country
United States
City
Coquitlam
State/Province
British Columbia
ZIP/Postal Code
V3K 3P4
Country
Canada
City
Kelowna
State/Province
British Columbia
ZIP/Postal Code
V1Y8E7
Country
Canada
City
St. John's
State/Province
Newfoundland and Labrador
ZIP/Postal Code
A1A 3R5
Country
Canada
City
Thornhill
State/Province
Ontario
ZIP/Postal Code
L4J 6W6
Country
Canada
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M9W 4L6
Country
Canada
City
Mirabel
State/Province
Quebec
ZIP/Postal Code
J7J 2K8
Country
Canada
City
Bydgoszcz
ZIP/Postal Code
85-168
Country
Poland
City
Elblag
ZIP/Postal Code
82-300
Country
Poland
City
Lublin
ZIP/Postal Code
20-607
Country
Poland
City
Poznan
ZIP/Postal Code
60-773
Country
Poland
City
Radom
ZIP/Postal Code
26-610
Country
Poland
City
Torun
ZIP/Postal Code
87-100
Country
Poland
City
Bilbao
ZIP/Postal Code
48903
Country
Spain
City
Donetsk
ZIP/Postal Code
83045
Country
Ukraine
City
Kharkiv
ZIP/Postal Code
61176
Country
Ukraine
City
Kyiv
ZIP/Postal Code
01610
Country
Ukraine
City
Kyiv
ZIP/Postal Code
02125
Country
Ukraine
City
Vinnytsya
ZIP/Postal Code
21081
Country
Ukraine
City
Blackpool
State/Province
Lancashire
ZIP/Postal Code
FY4 3AD
Country
United Kingdom

12. IPD Sharing Statement

Citations:
PubMed Identifier
26742777
Citation
Perez-Ruiz F, Sundy JS, Miner JN, Cravets M, Storgard C; RDEA594-203 Study Group. Lesinurad in combination with allopurinol: results of a phase 2, randomised, double-blind study in patients with gout with an inadequate response to allopurinol. Ann Rheum Dis. 2016 Jun;75(6):1074-80. doi: 10.1136/annrheumdis-2015-207919. Epub 2016 Jan 7.
Results Reference
derived

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Allopurinol Combination Study

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