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Infusion Duration Study To Assess Tolerability of Pegloticase Administered With a Shorter Infusion Duration in Subjects With Uncontrolled Gout Receiving Methotrexate

Primary Purpose

Chronic Uncontrolled Gout, Gout, Uncontrolled Gout

Status
Active
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Pegloticase with MTX
Sponsored by
Horizon Therapeutics Ireland DAC
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Chronic Uncontrolled Gout focused on measuring gout, uncontrolled gout

Eligibility Criteria

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

Inclusion Criteria:

  1. Adult men or women ≥18 years of age.
  2. Uncontrolled gout, defined as meeting the following criteria:

    • Hyperuricemia during the screening period defined as sUA ≥6 mg/dL
    • Failure to maintain normalization of sUA with xanthine oxidase inhibitors at the maximum medically appropriate dose, or with intolerable side effects or a contraindication to xanthine oxidase inhibitor therapy based on medical record review or subject interview.
    • Symptoms of gout including at least 1 of the following:

      • Presence of at least one tophus
      • Recurrent flares defined as 2 or more flares in the past 12 months prior to screening
      • Presence of chronic gouty arthritis
  3. Willing to discontinue all oral urate-lowering therapy at least 7 days prior to MTX dosing at Week -4 and remain off of urate lowering therapy when receiving pegloticase infusions during the study.

Exclusion Criteria:

  1. Severe chronic or recurrent bacterial infections, such as recurrent pneumonia or chronic bronchiectasis.
  2. Current or chronic treatment with systemic immunosuppressive agents such as MTX, azathioprine, or mycophenolate mofetil; prednisone ≥10 mg/day or equivalent dose of other corticosteroid on a chronic basis (defined as 3 months or longer) would also meet exclusion criteria.
  3. Glucose-6-phosphate dehydrogenase (G6PD) deficiency (tested at Screening Visit).
  4. Severe chronic renal impairment (estimated glomerular filtration rate <40 mL/min/1.73 m2) at the Screening Visit based on 4 variable-Modification of Diet in Renal Disease [MDRD] formula or currently on dialysis.
  5. Non-compensated congestive heart failure or hospitalization for congestive heart failure or treatment for acute coronary syndrome (myocardial infarction or unstable angina) within 3 months of the Screening Visit, or current uncontrolled arrhythmia, or current uncontrolled blood pressure (BP) (>160/100 mmHg) prior to Week -4.
  6. Pregnant, planning to become pregnant, breastfeeding, planning to impregnate female partner, or not on an effective form of birth control, as determined by the Investigator.
  7. Prior treatment with pegloticase (KRYSTEXXA), another recombinant uricase (rasburicase), or concomitant therapy with a polyethylene glycol-conjugated drug.
  8. Currently receiving systemic or radiologic treatment for ongoing cancer.
  9. History of malignancy within 5 years other than non-melanoma skin cancer or in situ carcinoma of cervix.

Sites / Locations

  • University of Alabama at Birmingham
  • Orthopedic Physicians Alaska
  • Arizona Arthritis & Rheumatology Research
  • Arthritis & Rheumatology Research
  • Arizona Arthritis & Rheumatology Research
  • Medvin Clinical Research
  • Amicis Research Center
  • Providence Saint John's Health Center
  • Medvin Clinical Research
  • Medvin Clinical Research
  • University of Colorado Division of Rheumatology
  • Denver Arthritis Clinic
  • Bradenton Research Center
  • Prohealth Research Center
  • LIFE Clinical Trials
  • D&H National Research Centers
  • IRIS Research and Development, LLC
  • Napa Research Center
  • D&H Tamarac Research Centers
  • GCP Clinical Research
  • ClinPro Research Solutions
  • ForCare Clinical Research
  • MedPharmics, LLC
  • MD Medical Research
  • Santa Fe Rheumatology
  • Long Island Arthritis & Osteoporosis Care
  • Research Carolina Elite
  • PMG Research of Hickory, LLC
  • Cape Fear Arthritis Care
  • PMG Research of Salisbury, LLC
  • Shelby Clinical Research, LLC
  • Velocity Clinical Research Cincinnati
  • Altoona Center for Clinical Research
  • Chattanooga Research & Medicine PLLC (CHARM)
  • Abigail Rebecca Neiman, MD, PA
  • Pioneer Research Solutions Inc - Houston
  • Velocity Clinical Research, Salt Lake City
  • Western Washington Medical Group
  • Arthritis Northwest

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Experimental

Experimental

Arm Label

Pegloticase 60 Minute Infusion with methotrexate (MTX)

Pegloticase 45 Minute Infusion with methotrexate (MTX)

Pegloticase 30 Minute Infusion with methotrexate (MTX)

Arm Description

Pegloticase 60 Minute Infusion with methotrexate (MTX). Participants will receive MTX (15 mg) (weekly) during the Run-in Period, then pegloticase (every 2 weeks) with MTX (weekly) for 24 weeks

Pegloticase 45 Minute Infusion with methotrexate (MTX). Participants will receive MTX (15 mg) (weekly) during the Run-in Period, then pegloticase (every 2 weeks) with MTX (weekly) for 24 weeks

Pegloticase 30 Minute Infusion with methotrexate (MTX). Participants will receive MTX (15 mg) (weekly) during the Run-in Period, then pegloticase (every 2 weeks) with MTX (weekly) for 24 weeks

Outcomes

Primary Outcome Measures

The incidence of participants experiencing Infusion Reactions (IRs), including anaphylaxis related to pegloticase

Secondary Outcome Measures

Proportion of Serum Uric Acid (sUA) Responders (sUA < 6 mg/dL) During Month 6
Responders are defined as participants achieving and maintaining sUA < 6 mg/dL for at least 80% of the time during Month 6. Participants meeting the sUA discontinuation criteria (pre-infusion sUA >6 mg/dL at 2 consecutive scheduled trial visits beginning with the Week 2 Visit) were counted as non-responders.
The proportion of participants who experienced any of the following events: IR leading to discontinuation of treatment, anaphylaxis, or meeting Individual participant sUA Discontinuation Criteria.
A participant meets the Individual participant sUA Discontinuation Criteria if he or she has a pre-infusion sUA level >6 mg/dL at 2 consecutive study visits beginning with the Week 2 Visit. When this occurs, the participants must discontinue treatment, and continues on the study.
Time to any of the following events: IR leading to discontinuation of treatment, anaphylaxis, or meeting individual participant sUA Discontinuation Criteria (two consecutive pre-infusion sUAs > 6mg/dL).
A participant meets the Individual participant sUA Discontinuation Criteria if he or she has a pre-infusion sUA level >6 mg/dL at 2 consecutive study visits beginning with the Week 2 Visit. When this occurs, the participants must discontinue treatment, and continues on the study.

Full Information

First Posted
August 11, 2020
Last Updated
October 18, 2023
Sponsor
Horizon Therapeutics Ireland DAC
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1. Study Identification

Unique Protocol Identification Number
NCT04511702
Brief Title
Infusion Duration Study To Assess Tolerability of Pegloticase Administered With a Shorter Infusion Duration in Subjects With Uncontrolled Gout Receiving Methotrexate
Official Title
A Phase 4, Multicenter, Open-Label, Infusion Duration Study To Assess Safety, Tolerability and Efficacy of Pegloticase Administered With a Shorter Infusion Duration in Subjects With Uncontrolled Gout Receiving Methotrexate
Study Type
Interventional

2. Study Status

Record Verification Date
October 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
October 2, 2020 (Actual)
Primary Completion Date
March 8, 2024 (Anticipated)
Study Completion Date
March 20, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Horizon Therapeutics Ireland DAC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes

5. Study Description

Brief Summary
The purpose of this study is to assess the safety, tolerability and efficiency of pegloticase administered with a shorter infusion duration in participants with uncontrolled gout receiving methotrexate.
Detailed Description
Approximately 180 participants will be enrolled. After a 4-week methotrexate run-in period, participants will be treated for up to 24 weeks with weekly oral methotrexate and biweekly 8mg pegloticase infusions. Up to three pegloticase infusion durations will be assessed in the study: 60-minute infusion, 45-minute infusion and 30-minute infusion. Safety evaluations will be performed regularly throughout the course of the study.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Chronic Uncontrolled Gout, Gout, Uncontrolled Gout
Keywords
gout, uncontrolled gout

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Sequential Assignment
Model Description
Three different infusion durations may be used. 60-minute infusion, 45-minute infusion and 30-minute.
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
191 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Pegloticase 60 Minute Infusion with methotrexate (MTX)
Arm Type
Experimental
Arm Description
Pegloticase 60 Minute Infusion with methotrexate (MTX). Participants will receive MTX (15 mg) (weekly) during the Run-in Period, then pegloticase (every 2 weeks) with MTX (weekly) for 24 weeks
Arm Title
Pegloticase 45 Minute Infusion with methotrexate (MTX)
Arm Type
Experimental
Arm Description
Pegloticase 45 Minute Infusion with methotrexate (MTX). Participants will receive MTX (15 mg) (weekly) during the Run-in Period, then pegloticase (every 2 weeks) with MTX (weekly) for 24 weeks
Arm Title
Pegloticase 30 Minute Infusion with methotrexate (MTX)
Arm Type
Experimental
Arm Description
Pegloticase 30 Minute Infusion with methotrexate (MTX). Participants will receive MTX (15 mg) (weekly) during the Run-in Period, then pegloticase (every 2 weeks) with MTX (weekly) for 24 weeks
Intervention Type
Biological
Intervention Name(s)
Pegloticase with MTX
Other Intervention Name(s)
Methotrexate
Intervention Description
Participants will receive MTX during the run-in period then pegloticase with MTX for up to 24 weeks during the treatment period
Primary Outcome Measure Information:
Title
The incidence of participants experiencing Infusion Reactions (IRs), including anaphylaxis related to pegloticase
Time Frame
Day 1 through Week 24.
Secondary Outcome Measure Information:
Title
Proportion of Serum Uric Acid (sUA) Responders (sUA < 6 mg/dL) During Month 6
Description
Responders are defined as participants achieving and maintaining sUA < 6 mg/dL for at least 80% of the time during Month 6. Participants meeting the sUA discontinuation criteria (pre-infusion sUA >6 mg/dL at 2 consecutive scheduled trial visits beginning with the Week 2 Visit) were counted as non-responders.
Time Frame
Month 6 (Weeks 20, 22, 24)
Title
The proportion of participants who experienced any of the following events: IR leading to discontinuation of treatment, anaphylaxis, or meeting Individual participant sUA Discontinuation Criteria.
Description
A participant meets the Individual participant sUA Discontinuation Criteria if he or she has a pre-infusion sUA level >6 mg/dL at 2 consecutive study visits beginning with the Week 2 Visit. When this occurs, the participants must discontinue treatment, and continues on the study.
Time Frame
Day 1 to Week 24
Title
Time to any of the following events: IR leading to discontinuation of treatment, anaphylaxis, or meeting individual participant sUA Discontinuation Criteria (two consecutive pre-infusion sUAs > 6mg/dL).
Description
A participant meets the Individual participant sUA Discontinuation Criteria if he or she has a pre-infusion sUA level >6 mg/dL at 2 consecutive study visits beginning with the Week 2 Visit. When this occurs, the participants must discontinue treatment, and continues on the study.
Time Frame
Day 1 to Week 24

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Adult men or women ≥18 years of age. Uncontrolled gout, defined as meeting the following criteria: Hyperuricemia during the screening period defined as sUA ≥6 mg/dL Failure to maintain normalization of sUA with xanthine oxidase inhibitors at the maximum medically appropriate dose, or with intolerable side effects or a contraindication to xanthine oxidase inhibitor therapy based on medical record review or subject interview. Symptoms of gout including at least 1 of the following: Presence of at least one tophus Recurrent flares defined as 2 or more flares in the past 12 months prior to screening Presence of chronic gouty arthritis Willing to discontinue all oral urate-lowering therapy at least 7 days prior to MTX dosing at Week -4 and remain off of urate lowering therapy when receiving pegloticase infusions during the study. Exclusion Criteria: Severe chronic or recurrent bacterial infections, such as recurrent pneumonia or chronic bronchiectasis. Current or chronic treatment with systemic immunosuppressive agents such as MTX, azathioprine, or mycophenolate mofetil; prednisone ≥10 mg/day or equivalent dose of other corticosteroid on a chronic basis (defined as 3 months or longer) would also meet exclusion criteria. Glucose-6-phosphate dehydrogenase (G6PD) deficiency (tested at Screening Visit). Severe chronic renal impairment (estimated glomerular filtration rate <40 mL/min/1.73 m2) at the Screening Visit based on 4 variable-Modification of Diet in Renal Disease [MDRD] formula or currently on dialysis. Non-compensated congestive heart failure or hospitalization for congestive heart failure or treatment for acute coronary syndrome (myocardial infarction or unstable angina) within 3 months of the Screening Visit, or current uncontrolled arrhythmia, or current uncontrolled blood pressure (BP) (>160/100 mmHg) prior to Week -4. Pregnant, planning to become pregnant, breastfeeding, planning to impregnate female partner, or not on an effective form of birth control, as determined by the Investigator. Prior treatment with pegloticase (KRYSTEXXA), another recombinant uricase (rasburicase), or concomitant therapy with a polyethylene glycol-conjugated drug. Currently receiving systemic or radiologic treatment for ongoing cancer. History of malignancy within 5 years other than non-melanoma skin cancer or in situ carcinoma of cervix.
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Supra Verma, MD
Organizational Affiliation
Horizon Therapeutics Ireland DAC
Official's Role
Study Director
Facility Information:
Facility Name
University of Alabama at Birmingham
City
Birmingham
State/Province
Alabama
ZIP/Postal Code
35294
Country
United States
Facility Name
Orthopedic Physicians Alaska
City
Anchorage
State/Province
Alaska
ZIP/Postal Code
99508
Country
United States
Facility Name
Arizona Arthritis & Rheumatology Research
City
Gilbert
State/Province
Arizona
ZIP/Postal Code
85297
Country
United States
Facility Name
Arthritis & Rheumatology Research
City
Mesa
State/Province
Arizona
ZIP/Postal Code
85210
Country
United States
Facility Name
Arizona Arthritis & Rheumatology Research
City
Phoenix
State/Province
Arizona
ZIP/Postal Code
85037
Country
United States
Facility Name
Medvin Clinical Research
City
Covina
State/Province
California
ZIP/Postal Code
91722
Country
United States
Facility Name
Amicis Research Center
City
Northridge
State/Province
California
ZIP/Postal Code
91324
Country
United States
Facility Name
Providence Saint John's Health Center
City
Santa Monica
State/Province
California
ZIP/Postal Code
90404
Country
United States
Facility Name
Medvin Clinical Research
City
Thousand Oaks
State/Province
California
ZIP/Postal Code
91360
Country
United States
Facility Name
Medvin Clinical Research
City
Tujunga
State/Province
California
ZIP/Postal Code
91042
Country
United States
Facility Name
University of Colorado Division of Rheumatology
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States
Facility Name
Denver Arthritis Clinic
City
Denver
State/Province
Colorado
ZIP/Postal Code
80230
Country
United States
Facility Name
Bradenton Research Center
City
Bradenton
State/Province
Florida
ZIP/Postal Code
34205
Country
United States
Facility Name
Prohealth Research Center
City
Doral
State/Province
Florida
ZIP/Postal Code
33166
Country
United States
Facility Name
LIFE Clinical Trials
City
Margate
State/Province
Florida
ZIP/Postal Code
33063
Country
United States
Facility Name
D&H National Research Centers
City
Miami
State/Province
Florida
ZIP/Postal Code
33155
Country
United States
Facility Name
IRIS Research and Development, LLC
City
Plantation
State/Province
Florida
ZIP/Postal Code
33324
Country
United States
Facility Name
Napa Research Center
City
Pompano Beach
State/Province
Florida
ZIP/Postal Code
33064
Country
United States
Facility Name
D&H Tamarac Research Centers
City
Tamarac
State/Province
Florida
ZIP/Postal Code
33321
Country
United States
Facility Name
GCP Clinical Research
City
Tampa
State/Province
Florida
ZIP/Postal Code
33064
Country
United States
Facility Name
ClinPro Research Solutions
City
Tampa
State/Province
Florida
ZIP/Postal Code
33609
Country
United States
Facility Name
ForCare Clinical Research
City
Tampa
State/Province
Florida
ZIP/Postal Code
33613
Country
United States
Facility Name
MedPharmics, LLC
City
Metairie
State/Province
Louisiana
ZIP/Postal Code
70006
Country
United States
Facility Name
MD Medical Research
City
Oxon Hill
State/Province
Maryland
ZIP/Postal Code
20745
Country
United States
Facility Name
Santa Fe Rheumatology
City
Santa Fe
State/Province
New Mexico
ZIP/Postal Code
87505
Country
United States
Facility Name
Long Island Arthritis & Osteoporosis Care
City
Babylon
State/Province
New York
ZIP/Postal Code
11702
Country
United States
Facility Name
Research Carolina Elite
City
Denver
State/Province
North Carolina
ZIP/Postal Code
28037
Country
United States
Facility Name
PMG Research of Hickory, LLC
City
Hickory
State/Province
North Carolina
ZIP/Postal Code
28602
Country
United States
Facility Name
Cape Fear Arthritis Care
City
Leland
State/Province
North Carolina
ZIP/Postal Code
28451
Country
United States
Facility Name
PMG Research of Salisbury, LLC
City
Salisbury
State/Province
North Carolina
ZIP/Postal Code
28144
Country
United States
Facility Name
Shelby Clinical Research, LLC
City
Shelby
State/Province
North Carolina
ZIP/Postal Code
28150
Country
United States
Facility Name
Velocity Clinical Research Cincinnati
City
Cincinnati
State/Province
Ohio
ZIP/Postal Code
45242
Country
United States
Facility Name
Altoona Center for Clinical Research
City
Duncansville
State/Province
Pennsylvania
ZIP/Postal Code
16635
Country
United States
Facility Name
Chattanooga Research & Medicine PLLC (CHARM)
City
Chattanooga
State/Province
Tennessee
ZIP/Postal Code
37404
Country
United States
Facility Name
Abigail Rebecca Neiman, MD, PA
City
Houston
State/Province
Texas
ZIP/Postal Code
77024
Country
United States
Facility Name
Pioneer Research Solutions Inc - Houston
City
Houston
State/Province
Texas
ZIP/Postal Code
77099
Country
United States
Facility Name
Velocity Clinical Research, Salt Lake City
City
West Jordan
State/Province
Utah
ZIP/Postal Code
84088
Country
United States
Facility Name
Western Washington Medical Group
City
Bothell
State/Province
Washington
ZIP/Postal Code
98021
Country
United States
Facility Name
Arthritis Northwest
City
Spokane
State/Province
Washington
ZIP/Postal Code
99204
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
Undecided

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Infusion Duration Study To Assess Tolerability of Pegloticase Administered With a Shorter Infusion Duration in Subjects With Uncontrolled Gout Receiving Methotrexate

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