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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

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

Status
Completed
Phases
Phase 4
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04511702
Enrollment
191
Registered
2020-08-13
Start date
2020-10-02
Completion date
2024-03-25
Last updated
2025-10-17

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Chronic Uncontrolled Gout, Gout, Uncontrolled Gout

Keywords

gout, uncontrolled gout

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. Acquired from Horizon in 2024.

Interventions

BIOLOGICALPegloticase with MTX

Participants will receive MTX during the run-in period then pegloticase with MTX for up to 24 weeks during the treatment period

Sponsors

Amgen
Lead SponsorINDUSTRY

Study design

Allocation
NON_RANDOMIZED
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Intervention model description

Three different infusion durations may be used. 60-minute infusion, 45-minute infusion and 30-minute.

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

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

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who Experienced an Infusion Reaction (IR), Including Anaphylaxis, Related to Pegloticase From Day 1 to Week 24Day 1 to Week 24IRs, including anaphylaxis, were assessed after each infusion for a period of 24 weeks. IRs were defined as any infusion-related adverse event (AE) or cluster of temporally-related AEs, not attributable to another cause, which occurred during the pegloticase infusion and up to 2 hours post-infusion. Additional AEs occurring outside of the 2-hour window following infusion could also be categorized as an IR at the Principal Investigator's discretion.

Secondary

MeasureTime frameDescription
Percentage of Serum Uric Acid (sUA) Responders at Month 6Up to 6 monthsResponders were defined as participants who achieved and maintained sUA levels below 6 mg/dL for at least 80% of the time during month 6. Responders who met sUA discontinuation criteria (2 consecutive sUA \> 6 mg/dL), regardless of treatment status were considered non-responders.
Percentage of Participants Who Experienced an IR Leading to Discontinuation of Treatment, Anaphylaxis or Met sUA Discontinuation CriteriaDay 1 to Week 24IRs were defined as any infusion-related AE or cluster of temporally-related AEs, not attributable to another cause, which occurred during the pegloticase infusion and for 2 hours post-infusion. Other AEs that occurred outside of the 2 hour window following the infusion may have also been categorized as an IR at the Principal Investigator's discretion. Anaphylaxis was defined using the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria. Meeting individual sUA discontinuation criteria was defined as two consecutive pre-infusion sUAs \> 6 mg/dL after Day 1.
Time to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in All ParticipantsDay 1 to Week 24Infusion reactions were defined as any infusion-related adverse event or cluster of temporally-related adverse events, not attributable to another cause, which occurred during the infusion and for 2 hours post-infusion. Other adverse events that occurred outside of the 2-hour window following the infusion may have also been categorized as an infusion reaction at the Principal Investigator's discretion. Anaphylaxis was defined using the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria. Meeting individual serum uric acid discontinuation criteria was defined as two consecutive pre-infusion serum uric acid levels greater than 6 mg/dL after Day 1. Time to event was derived as the date of the event minus the date of the first dose of the treatment plus 1. All participants were censored at the date of their last infusion.
Time to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in Participants With an EventDay 1 to Week 24IRs were defined as any infusion-related adverse event or cluster of temporally-related adverse events, not attributable to another cause, which occurred during the infusion and for 2 hours post-infusion. Other adverse events that occurred outside of the 2-hour window following the infusion may have also been categorized as an infusion reaction at the Principal Investigator's discretion. Anaphylaxis was defined using the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria. Meeting individual serum uric acid discontinuation criteria was defined as two consecutive pre-infusion serum uric acid levels greater than 6 mg/dL after Day 1. Time to event was derived as the date of the event minus the date of the first dose of the treatment plus 1. Only participants who experienced an event were included in this analysis.

Countries

United States

Participant flow

Recruitment details

Participants with uncontrolled gout were enrolled at 36 centers across the United States between October 2020 and March 2024.

Pre-assignment details

A 4-week methotrexate (MTX) run-in period, with a weekly dose of 15 mg, was used to identify screening failures due to MTX intolerance. All participants who completed the run-in period received their first dose of pegloticase on Day 1, followed by additional doses every 2 weeks (Q2W) for a total of 22 weeks.

Participants by arm

ArmCount
Pegloticase 60 Minute + MTX
Participants received oral MTX (15 mg) (weekly) during the Run-in Period, then 60-minute pegloticase IV infusions (every 2 weeks) with MTX (weekly) for 24 weeks.
116
Pegloticase 45 Minute + MTX
Participants received oral MTX (15 mg) (weekly) during the Run-in Period, then 45-minute pegloticase IV infusions (every 2 weeks) with MTX (weekly) for 24 weeks.
13
Pegloticase 30 Minute + MTX
Participants received oral MTX (15 mg) (weekly) during the Run-in Period, then 30-minute pegloticase IV infusions (every 2 weeks) with MTX (weekly) for 24 weeks.
62
Total191

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Overall StudyLost to Follow-up304
Overall StudyWithdrawal by Subject1718

Baseline characteristics

CharacteristicTotalPegloticase 30 Minute + MTXPegloticase 45 Minute + MTXPegloticase 60 Minute + MTX
Age, Continuous56.2 Years
STANDARD_DEVIATION 11.2
56.9 Years
STANDARD_DEVIATION 11.04
61.1 Years
STANDARD_DEVIATION 9.96
55.2 Years
STANDARD_DEVIATION 11.33
Race/Ethnicity, Customized
American Indian or Alaska Native
1 Participants1 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Asian
11 Participants2 Participants1 Participants8 Participants
Race/Ethnicity, Customized
Black or African American
30 Participants9 Participants3 Participants18 Participants
Race/Ethnicity, Customized
Hispanic or Latino
34 Participants4 Participants1 Participants29 Participants
Race/Ethnicity, Customized
More than 1 race
4 Participants1 Participants0 Participants3 Participants
Race/Ethnicity, Customized
Native Hawaiian or Other Pacific Islander
1 Participants1 Participants0 Participants0 Participants
Race/Ethnicity, Customized
Not Hispanic or Latino
157 Participants58 Participants12 Participants87 Participants
Race/Ethnicity, Customized
Other
3 Participants0 Participants0 Participants3 Participants
Race/Ethnicity, Customized
White
141 Participants48 Participants9 Participants84 Participants
Sex: Female, Male
Female
23 Participants9 Participants2 Participants12 Participants
Sex: Female, Male
Male
168 Participants53 Participants11 Participants104 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
deaths
Total, all-cause mortality
0 / 2150 / 1160 / 130 / 62
other
Total, other adverse events
79 / 21586 / 11613 / 1346 / 62
serious
Total, serious adverse events
1 / 2154 / 1160 / 135 / 62

Outcome results

Primary

Percentage of Participants Who Experienced an Infusion Reaction (IR), Including Anaphylaxis, Related to Pegloticase From Day 1 to Week 24

IRs, including anaphylaxis, were assessed after each infusion for a period of 24 weeks. IRs were defined as any infusion-related adverse event (AE) or cluster of temporally-related AEs, not attributable to another cause, which occurred during the pegloticase infusion and up to 2 hours post-infusion. Additional AEs occurring outside of the 2-hour window following infusion could also be categorized as an IR at the Principal Investigator's discretion.

Time frame: Day 1 to Week 24

Population: Safety Analysis Set (SAS): All participants who received at least 1 dose of pegloticase.

ArmMeasureValue (NUMBER)
Pegloticase 60 Minute + MTXPercentage of Participants Who Experienced an Infusion Reaction (IR), Including Anaphylaxis, Related to Pegloticase From Day 1 to Week 246.0 Percentage of Participants
Pegloticase 45 Minute + MTXPercentage of Participants Who Experienced an Infusion Reaction (IR), Including Anaphylaxis, Related to Pegloticase From Day 1 to Week 240 Percentage of Participants
Pegloticase 30 Minute + MTXPercentage of Participants Who Experienced an Infusion Reaction (IR), Including Anaphylaxis, Related to Pegloticase From Day 1 to Week 2412.9 Percentage of Participants
Secondary

Percentage of Participants Who Experienced an IR Leading to Discontinuation of Treatment, Anaphylaxis or Met sUA Discontinuation Criteria

IRs were defined as any infusion-related AE or cluster of temporally-related AEs, not attributable to another cause, which occurred during the pegloticase infusion and for 2 hours post-infusion. Other AEs that occurred outside of the 2 hour window following the infusion may have also been categorized as an IR at the Principal Investigator's discretion. Anaphylaxis was defined using the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria. Meeting individual sUA discontinuation criteria was defined as two consecutive pre-infusion sUAs \> 6 mg/dL after Day 1.

Time frame: Day 1 to Week 24

Population: SAS: All participants who received at least 1 dose of pegloticase.

ArmMeasureValue (NUMBER)
Pegloticase 60 Minute + MTXPercentage of Participants Who Experienced an IR Leading to Discontinuation of Treatment, Anaphylaxis or Met sUA Discontinuation Criteria19.0 Percentage of Participants
Pegloticase 45 Minute + MTXPercentage of Participants Who Experienced an IR Leading to Discontinuation of Treatment, Anaphylaxis or Met sUA Discontinuation Criteria7.7 Percentage of Participants
Pegloticase 30 Minute + MTXPercentage of Participants Who Experienced an IR Leading to Discontinuation of Treatment, Anaphylaxis or Met sUA Discontinuation Criteria32.3 Percentage of Participants
Secondary

Percentage of Serum Uric Acid (sUA) Responders at Month 6

Responders were defined as participants who achieved and maintained sUA levels below 6 mg/dL for at least 80% of the time during month 6. Responders who met sUA discontinuation criteria (2 consecutive sUA \> 6 mg/dL), regardless of treatment status were considered non-responders.

Time frame: Up to 6 months

Population: mITT Analysis Set: All participants who received at least 1 dose of pegloticase.

ArmMeasureValue (NUMBER)
Pegloticase 60 Minute + MTXPercentage of Serum Uric Acid (sUA) Responders at Month 667.2 Percentage of Participants
Pegloticase 45 Minute + MTXPercentage of Serum Uric Acid (sUA) Responders at Month 676.9 Percentage of Participants
Pegloticase 30 Minute + MTXPercentage of Serum Uric Acid (sUA) Responders at Month 656.5 Percentage of Participants
Secondary

Time to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in All Participants

Infusion reactions were defined as any infusion-related adverse event or cluster of temporally-related adverse events, not attributable to another cause, which occurred during the infusion and for 2 hours post-infusion. Other adverse events that occurred outside of the 2-hour window following the infusion may have also been categorized as an infusion reaction at the Principal Investigator's discretion. Anaphylaxis was defined using the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria. Meeting individual serum uric acid discontinuation criteria was defined as two consecutive pre-infusion serum uric acid levels greater than 6 mg/dL after Day 1. Time to event was derived as the date of the event minus the date of the first dose of the treatment plus 1. All participants were censored at the date of their last infusion.

Time frame: Day 1 to Week 24

Population: SAS: All participants who received at least 1 dose of pegloticase.

ArmMeasureValue (MEDIAN)
Pegloticase 60 Minute + MTXTime to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in All ParticipantsNA Days
Pegloticase 45 Minute + MTXTime to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in All ParticipantsNA Days
Pegloticase 30 Minute + MTXTime to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in All ParticipantsNA Days
Secondary

Time to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in Participants With an Event

IRs were defined as any infusion-related adverse event or cluster of temporally-related adverse events, not attributable to another cause, which occurred during the infusion and for 2 hours post-infusion. Other adverse events that occurred outside of the 2-hour window following the infusion may have also been categorized as an infusion reaction at the Principal Investigator's discretion. Anaphylaxis was defined using the National Institute of Allergy and Infectious Diseases/Food Allergy and Anaphylaxis Network criteria. Meeting individual serum uric acid discontinuation criteria was defined as two consecutive pre-infusion serum uric acid levels greater than 6 mg/dL after Day 1. Time to event was derived as the date of the event minus the date of the first dose of the treatment plus 1. Only participants who experienced an event were included in this analysis.

Time frame: Day 1 to Week 24

Population: All participants who received at least 1 dose of pegloticase and experienced an IR leading to discontinuation of treatment, anaphylaxis or met sUA discontinuation criteria.

ArmMeasureValue (MEDIAN)
Pegloticase 60 Minute + MTXTime to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in Participants With an Event17.0 Days
Pegloticase 45 Minute + MTXTime to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in Participants With an Event15.0 Days
Pegloticase 30 Minute + MTXTime to First Event of IR Leading to Discontinuation of Treatment, Anaphylaxis or Meeting sUA Discontinuation Criteria in Participants With an Event43.0 Days

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026