Gout
Conditions
Brief summary
The purpose of this study was to determine the safety and tolerability of rilonacept for participants with gout who were initiating allopurinol.
Interventions
Rilonacept 160 mg loading dose followed by Rilonacept 80 mg/2 mL injections qw for 52 weeks.
Placebo loading dose followed by placebo injections (2 mL) qw for 52 weeks.
Allopurinol 50 or 100 mg, orally daily for 52 weeks as background treatment.
Sponsors
Study design
Eligibility
Inclusion criteria
Key Inclusion criteria: * Male or female participants aged 18 to 80 years; * Previously met the preliminary criteria of the ARA for the classification of the acute arthritis of primary gout; * Serum uric acid greater than or equal to 7.5 mg/dL at the screening visit; * A self-reported history of at least 2 gout flares in the year prior to screening.
Exclusion criteria
Key
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | Day 1 to Day 392 (Week 56) | Any untoward medical occurrence in a participant who received investigational medicinal product (IMP) was considered an AE without regard to possibility of causal relationship with this treatment. TEAEs were defined as AEs that developed or worsened or became serious during on-treatment period (time from the administration of first dose of study drug up to and including 35 days after the last dose of study drug). A serious adverse event (SAE) was defined as any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. Any TEAE included participants with both serious and non-serious AEs. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With at Least One Gout Flare From Day 1 to Day 168 (Week 24) | Day 1 to Day 168 (Week 24) | Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain; and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least one gout flare at Week 24 was to be reported for this outcome measure. |
| Percentage of Participants With at Least Two Gout Flares From Day 1 to Day 168 (Week 24) | Day 1 to Day 168 (Week 24) | Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain, and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least two gout flares at Week 24 was to be reported for this outcome measure. |
| Percentage of Participants With at Least One Gout Flare From Day 1 to Day 364 (Week 52) | Day 1 to Day 364 (Week 52) | Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain; and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least one gout flare at Week 52 was to be reported for this outcome measure. |
| Percentage of Participants With at Least Two Gout Flares From Day 1 to Day 364 (Week 52) | Day 1 to Day 364 (Week 52) | Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain, and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least two gout flares at Week 52 was to be reported for this outcome measure. |
| Percentage of Participants With Rescue Medication From Day 1 to Day 364 (Week 52) | Day 1 to Day 364 (Week 52) | Participants who required rescue medication after having 2 or more gout flares during the treatment period were evaluated. |
Countries
United States
Participant flow
Recruitment details
The study was conducted at 60 study sites in the United States (US) from 12 November 2011 to 02 November 2012. A total of 485 participants were screened in the study.
Pre-assignment details
Out of 485 participants, 220 were randomized and treated in the study. Participants were randomized in 4:3 ratio to receive either Rilonacept 80 mg or Placebo.
Participants by arm
| Arm | Count |
|---|---|
| Placebo Two subcutaneous injections of Placebo (for Rilonacept) as a loading dose on Day 1 followed by a single injection qw from Week 1 to Week 51. | 94 |
| Rilonacept 80 mg Two subcutaneous injections of Rilonacept 80 mg (for a total of 160 mg) as a loading dose on Day 1, followed by a single 80 mg injection of Rilonacept qw from Week 1 to Week 51. | 126 |
| Total | 220 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Adverse Event | 5 | 5 |
| Overall Study | Decision by the sponsor | 75 | 108 |
| Overall Study | Lost to Follow-up | 5 | 4 |
| Overall Study | Non compliance with protocol | 2 | 4 |
| Overall Study | Reason unspecified | 1 | 2 |
| Overall Study | Withdrawal by Subject | 6 | 3 |
Baseline characteristics
| Characteristic | Placebo | Rilonacept 80 mg | Total |
|---|---|---|---|
| Age, Continuous | 51.5 years STANDARD_DEVIATION 10.69 | 52.1 years STANDARD_DEVIATION 11.18 | 51.9 years STANDARD_DEVIATION 10.95 |
| Ethnicity (NIH/OMB) Hispanic or Latino | 7 Participants | 6 Participants | 13 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 87 Participants | 120 Participants | 207 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 1 Participants | 0 Participants | 1 Participants |
| Race (NIH/OMB) Asian | 2 Participants | 9 Participants | 11 Participants |
| Race (NIH/OMB) Black or African American | 16 Participants | 27 Participants | 43 Participants |
| Race (NIH/OMB) More than one race | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants | 3 Participants | 3 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 0 Participants | 0 Participants | 0 Participants |
| Race (NIH/OMB) White | 75 Participants | 87 Participants | 162 Participants |
| Sex: Female, Male Female | 8 Participants | 15 Participants | 23 Participants |
| Sex: Female, Male Male | 86 Participants | 111 Participants | 197 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 31 / 94 | 43 / 126 |
| serious Total, serious adverse events | 5 / 94 | 5 / 126 |
Outcome results
Percentage of Participants With Treatment Emergent Adverse Events (TEAEs)
Any untoward medical occurrence in a participant who received investigational medicinal product (IMP) was considered an AE without regard to possibility of causal relationship with this treatment. TEAEs were defined as AEs that developed or worsened or became serious during on-treatment period (time from the administration of first dose of study drug up to and including 35 days after the last dose of study drug). A serious adverse event (SAE) was defined as any untoward medical occurrence that resulted in any of the following outcomes: death, life-threatening, required initial or prolonged in-patient hospitalization, persistent or significant disability/incapacity, congenital anomaly/birth defect, or considered as medically important event. Any TEAE included participants with both serious and non-serious AEs.
Time frame: Day 1 to Day 392 (Week 56)
Population: Safety analysis set (SAF) that included all randomized participants who received any study medication and was based on the treatment received (as treated).
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Placebo | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With TEAEs related to study drug | 12.8 percentage of participants |
| Placebo | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With TEAEs resulting in study drug discontinuation | 10.6 percentage of participants |
| Placebo | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With serious TEAEs | 5.3 percentage of participants |
| Placebo | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With TEAEs resulting in death | 0.0 percentage of participants |
| Placebo | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With at least one TEAE | 68.1 percentage of participants |
| Rilonacept 80 mg | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With TEAEs resulting in death | 0.0 percentage of participants |
| Rilonacept 80 mg | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With at least one TEAE | 68.3 percentage of participants |
| Rilonacept 80 mg | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With TEAEs related to study drug | 19.0 percentage of participants |
| Rilonacept 80 mg | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With serious TEAEs | 4.0 percentage of participants |
| Rilonacept 80 mg | Percentage of Participants With Treatment Emergent Adverse Events (TEAEs) | With TEAEs resulting in study drug discontinuation | 6.3 percentage of participants |
Percentage of Participants With at Least One Gout Flare From Day 1 to Day 168 (Week 24)
Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain; and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least one gout flare at Week 24 was to be reported for this outcome measure.
Time frame: Day 1 to Day 168 (Week 24)
Population: As per sponsor's discretion, the study was discontinued due to which data for this outcome measure was not collected and hence, not analyzed and reported.
Percentage of Participants With at Least One Gout Flare From Day 1 to Day 364 (Week 52)
Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain; and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least one gout flare at Week 52 was to be reported for this outcome measure.
Time frame: Day 1 to Day 364 (Week 52)
Population: As per sponsor's discretion, the study was discontinued due to which data for this outcome measure was not collected and hence, not analyzed and reported.
Percentage of Participants With at Least Two Gout Flares From Day 1 to Day 168 (Week 24)
Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain, and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least two gout flares at Week 24 was to be reported for this outcome measure.
Time frame: Day 1 to Day 168 (Week 24)
Population: As per sponsor's discretion, the study was discontinued due to which data for this outcome measure was not collected and hence, not analyzed and reported.
Percentage of Participants With at Least Two Gout Flares From Day 1 to Day 364 (Week 52)
Gout flare was defined as acute articular pain typical of a gout attack that required treatment with an anti-inflammatory therapeutic: had at least 3 of the following 4 signs or symptoms: joint swelling, tenderness, redness, and pain, and with at least 1 of the following: rapid onset of pain, decreased range of motion, joint warmth or other symptoms similar to a prior gout flare. Percentage of participants with at least two gout flares at Week 52 was to be reported for this outcome measure.
Time frame: Day 1 to Day 364 (Week 52)
Population: As per sponsor's discretion, the study was discontinued due to which data for this outcome measure was not collected and hence, not analyzed and reported.
Percentage of Participants With Rescue Medication From Day 1 to Day 364 (Week 52)
Participants who required rescue medication after having 2 or more gout flares during the treatment period were evaluated.
Time frame: Day 1 to Day 364 (Week 52)
Population: Safety analysis set (SAF) that included all randomized participants who received any study medication and was based on the treatment received (as treated).
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Placebo | Percentage of Participants With Rescue Medication From Day 1 to Day 364 (Week 52) | 22.3 percentage of participants |
| Rilonacept 80 mg | Percentage of Participants With Rescue Medication From Day 1 to Day 364 (Week 52) | 8.7 percentage of participants |