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Pilot Study Evaluating The Efficacy Of Etanercept In Acute Gout

Primary Purpose

Gout Attack

Status
Suspended
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Etanercept
Triamcinolone Acetonide
Sponsored by
Rutgers, The State University of New Jersey
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Gout Attack

Eligibility Criteria

18 Years - 85 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Key Inclusion Criteria:

  1. Male or female patients age ≥18 to ≤85 year
  2. History of established gout
  3. Onset of current acute gout attack within 4 days prior to randomization with: presence of any warm joint, swollen joint, pain score at rest ≥5 on the 0-10 pain scale, patient self-report of acute gout attack
  4. Baseline pain intensity ≥5 on a 0-10 pain scale;
  5. Tender (≥1 on a 0-4-point Likert scale) and swollen (≥1 on a 0-4-point Likert scale) index joint;
  6. If on urate-lowering therapy, a stable dose and regimen for at least 2 weeks prior to randomization, and expectance to remain on a stable dose and regimen for the duration of the double-blind treatment period, and;
  7. Body mass index (BMI) ≤45 kg/m2.

Exclusion Criteria:

  1. Use of intra-articular or IM corticosteroids within 14 days prior to screening;
  2. Use of an IL-1 inhibitor, TNF inhibitor or other biologic or investigational drug within 30 days prior to screening;
  3. History of a drug allergy to either study drug;
  4. Diagnosis or history of:

    1. rheumatoid arthritis (RA);
    2. infectious/septic or other inflammatory arthritis;
    3. alcoholic hepatitis or nonalcoholic steatohepatitis;
    4. immunodeficiency syndromes, including Human Immunodeficiency Virus (HIV) infection;
    5. Stage IIIb, IV, or V chronic kidney disease;
    6. idiopathic thrombocytopenic purpura;
    7. active, severe chronic pulmonary disease (eg, requiring oxygen therapy);
    8. uncontrolled hypertension (≥ 200/105 mmHg);
    9. symptomatic (New York Heart Association Class II, III, or IV) congestive heart failure;
    10. uncontrolled diabetes Type I or II (recent blood glucose > 300 mg/dL);
    11. myocardial infarction, unstable cardiac arrhythmias or unstable symptomatic coronary ischemia, within the past 12 months before randomization;
    12. history of malignancy of any organ system within the past 5 years;
    13. multiple sclerosis or any other demyelinating disease, or;
    14. major chronic inflammatory disease or connective tissue disease other than RA or psoriatic arthritis (PsA), including but not limited to fibromyalgia or systemic lupus erythematosus (with the exception of secondary Sjögrens syndrome, etc.);
  5. Contraindication to IM injection;
  6. Donation or loss of ≥400 milliliters (mL) of blood in the 8 weeks before dosing;
  7. Any live vaccination in the 3 months before the start of the study;
  8. Active infection (including chronic or localized infections) for which antiinfectives were indicated within 4 weeks before screening;
  9. Any serious infection, defined as requiring hospitalization or intravenous anti-infectives, within 8 weeks before first dose of investigational product;
  10. Prosthetic joint infection within 5 years of screening, or native joint infection within 1 year of screening;
  11. Known alcohol addiction or dependency, daily alcohol use, or current substance use or abuse;
  12. Positive medical history for hepatitis B or C (subjects with a history of hepatitis B vaccination without history of hepatitis B infection are allowed to enroll);
  13. History of active tuberculosis;
  14. Positive test for tuberculosis during screening, defined as positive Purified Protein Derivative (PPD) skin test (≥5 mm induration at 48-72 hours after test is placed), or positive Quantiferon test;
  15. Pregnant or nursing (lactating) women
  16. Female patients who are physiologically capable of becoming pregnant must use an acceptable method of contraception

Sites / Locations

  • Rutgers, Robert Wood Johnson Medical School, Clinical Research Center

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Etanercept

Triamcinolone acetonide

Arm Description

Subjects will be administered etanercept 50 mg subcutaneously and a placebo intramuscularly

Subjects will be administered triamcinolone acetonide 40 mg intramuscularly and a placebo subcutaneously

Outcomes

Primary Outcome Measures

Joint pain intensity in the most affected joint
Pain intensity in the most affected baseline joint measured by the numeric 0-10 pain scale at 72 hours

Secondary Outcome Measures

Joint pain on numeric pain scale
Patient's assessment of joint pain intensity in the most affected baseline joint on a 0-10 pain scale, at Baseline and post-dose Days
Patient's assessment of response to treatment
Patient's global assessment of response to treatment
Physician's assessment of response to treatment
Physician's global assessment of response to treatment
Rescue Medication
Compare the use of rescue medication
Safety and Tolerability of Etanercept
Safety and tolerability as assessed by subjects with adverse events and serious adverse events from baseline through Visit 5 safety follow-up

Full Information

First Posted
August 13, 2018
Last Updated
May 10, 2021
Sponsor
Rutgers, The State University of New Jersey
Collaborators
Amgen
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1. Study Identification

Unique Protocol Identification Number
NCT03636373
Brief Title
Pilot Study Evaluating The Efficacy Of Etanercept In Acute Gout
Official Title
Investigator-Initiated, Pilot Study Evaluating The Efficacy Of Etanercept In Acute Gout
Study Type
Interventional

2. Study Status

Record Verification Date
May 2021
Overall Recruitment Status
Suspended
Why Stopped
Temporarily paused due to COVID 19 and expected to resume
Study Start Date
June 15, 2021 (Anticipated)
Primary Completion Date
June 15, 2022 (Anticipated)
Study Completion Date
December 15, 2022 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Rutgers, The State University of New Jersey
Collaborators
Amgen

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
Yes
Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this pilot study is to investigate the safety and efficacy of etanercept (Enbrel™; Amgen) for the treatment of an acute gout attack will be non-inferior to triamcinolone acetonide an FDA approved drug to treat acute gout attacks.

6. Conditions and Keywords

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

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Parallel Assignment
Model Description
Subjects will be administered a single dose of etanercept 50 mg subcutaneously (SC), at the onset of an acute gout attack, or a single dose of triamcinolone acetonide 40 mg intramuscularly (IM)
Masking
ParticipantCare ProviderInvestigator
Masking Description
Triple
Allocation
Randomized
Enrollment
40 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Etanercept
Arm Type
Experimental
Arm Description
Subjects will be administered etanercept 50 mg subcutaneously and a placebo intramuscularly
Arm Title
Triamcinolone acetonide
Arm Type
Active Comparator
Arm Description
Subjects will be administered triamcinolone acetonide 40 mg intramuscularly and a placebo subcutaneously
Intervention Type
Drug
Intervention Name(s)
Etanercept
Intervention Description
Subjects will receive 50 mg of study drug on visit 1. A second dose of study drug will be administered if the pain intensity is ≥ 5 on a pain scale of 0-10 at Visit 2
Intervention Type
Drug
Intervention Name(s)
Triamcinolone Acetonide
Intervention Description
Subjects will be administered triamcinolone acetonide 40 mg intramuscularly on visit 1. A second dose of drug will be administered if the pain intensity is ≥ 5 on a pain scale of 0-10 at Visit 2
Primary Outcome Measure Information:
Title
Joint pain intensity in the most affected joint
Description
Pain intensity in the most affected baseline joint measured by the numeric 0-10 pain scale at 72 hours
Time Frame
72 hours
Secondary Outcome Measure Information:
Title
Joint pain on numeric pain scale
Description
Patient's assessment of joint pain intensity in the most affected baseline joint on a 0-10 pain scale, at Baseline and post-dose Days
Time Frame
Days 4, 7, and 14
Title
Patient's assessment of response to treatment
Description
Patient's global assessment of response to treatment
Time Frame
Day 4, 7 and 14
Title
Physician's assessment of response to treatment
Description
Physician's global assessment of response to treatment
Time Frame
Post-dose days 4, 7 and 14
Title
Rescue Medication
Description
Compare the use of rescue medication
Time Frame
Days 4, 7, 14
Title
Safety and Tolerability of Etanercept
Description
Safety and tolerability as assessed by subjects with adverse events and serious adverse events from baseline through Visit 5 safety follow-up
Time Frame
During study

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
85 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Key Inclusion Criteria: Male or female patients age ≥18 to ≤85 year History of established gout Onset of current acute gout attack within 4 days prior to randomization with: presence of any warm joint, swollen joint, pain score at rest ≥5 on the 0-10 pain scale, patient self-report of acute gout attack Baseline pain intensity ≥5 on a 0-10 pain scale; Tender (≥1 on a 0-4-point Likert scale) and swollen (≥1 on a 0-4-point Likert scale) index joint; If on urate-lowering therapy, a stable dose and regimen for at least 2 weeks prior to randomization, and expectance to remain on a stable dose and regimen for the duration of the double-blind treatment period, and; Body mass index (BMI) ≤45 kg/m2. Exclusion Criteria: Use of intra-articular or IM corticosteroids within 14 days prior to screening; Use of an IL-1 inhibitor, TNF inhibitor or other biologic or investigational drug within 30 days prior to screening; History of a drug allergy to either study drug; Diagnosis or history of: rheumatoid arthritis (RA); infectious/septic or other inflammatory arthritis; alcoholic hepatitis or nonalcoholic steatohepatitis; immunodeficiency syndromes, including Human Immunodeficiency Virus (HIV) infection; Stage IIIb, IV, or V chronic kidney disease; idiopathic thrombocytopenic purpura; active, severe chronic pulmonary disease (eg, requiring oxygen therapy); uncontrolled hypertension (≥ 200/105 mmHg); symptomatic (New York Heart Association Class II, III, or IV) congestive heart failure; uncontrolled diabetes Type I or II (recent blood glucose > 300 mg/dL); myocardial infarction, unstable cardiac arrhythmias or unstable symptomatic coronary ischemia, within the past 12 months before randomization; history of malignancy of any organ system within the past 5 years; multiple sclerosis or any other demyelinating disease, or; major chronic inflammatory disease or connective tissue disease other than RA or psoriatic arthritis (PsA), including but not limited to fibromyalgia or systemic lupus erythematosus (with the exception of secondary Sjögrens syndrome, etc.); Contraindication to IM injection; Donation or loss of ≥400 milliliters (mL) of blood in the 8 weeks before dosing; Any live vaccination in the 3 months before the start of the study; Active infection (including chronic or localized infections) for which antiinfectives were indicated within 4 weeks before screening; Any serious infection, defined as requiring hospitalization or intravenous anti-infectives, within 8 weeks before first dose of investigational product; Prosthetic joint infection within 5 years of screening, or native joint infection within 1 year of screening; Known alcohol addiction or dependency, daily alcohol use, or current substance use or abuse; Positive medical history for hepatitis B or C (subjects with a history of hepatitis B vaccination without history of hepatitis B infection are allowed to enroll); History of active tuberculosis; Positive test for tuberculosis during screening, defined as positive Purified Protein Derivative (PPD) skin test (≥5 mm induration at 48-72 hours after test is placed), or positive Quantiferon test; Pregnant or nursing (lactating) women Female patients who are physiologically capable of becoming pregnant must use an acceptable method of contraception
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Naomi Schlesinger, MD
Organizational Affiliation
Rutgers Robert Wood Johnson Medical School/ Rutgers RWJMS Gout center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Rutgers, Robert Wood Johnson Medical School, Clinical Research Center
City
New Brunswick
State/Province
New Jersey
ZIP/Postal Code
08901
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Pilot Study Evaluating The Efficacy Of Etanercept In Acute Gout

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