A Phase 4, Open-label Study of KRYSTEXXA® (Pegloticase) Co-administered With Methotrexate (MTX) i… (NCT04762498) | Clinical Trial Compass
CompletedPhase 4
A Phase 4, Open-label Study of KRYSTEXXA® (Pegloticase) Co-administered With Methotrexate (MTX) in Patients With Uncontrolled Gout (FORWARD OL)
United States50 participantsStarted 2021-01-26
Plain-language summary
This trial is to assess efficacy, safety, blood levels and bodily effects of up to 2 dose levels of intravenous (IV) pegloticase (KRYSTEXXA) infusions at every 4 week intervals (Q4 Weeks) for up to 6 months (Day 1 to 24 weeks with an optional 24 - 48 weeks treatment duration) when given in combination with weekly oral doses of methotrexate (MTX). The goal is to identify an appropriate dose to be administered every 4 weeks to be used for future clinical trials for patients with chronic gout that does not adequately respond to conventional therapy.
Who can participate
Age range18 Years – 80 Years
SexALL
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Inclusion criteria
✓. Willing and able to give informed consent.
✓. Willing and able to comply with the prescribed treatment protocol and evaluations for the duration of the trial.
✓. Adult men or women ≥18 and \<80 years of age.
✓. Uncontrolled gout, defined as meeting the following criteria:
✓. Willing to discontinue any oral urate lowering therapy for at least 7 days prior to MTX dosing at Week -4 and remain off while receiving pegloticase treatments.
✓. Women of childbearing potential (including those with an onset of menopause \<2 years prior to screening, non-therapy-induced amenorrhea for \<12 months prior to screening, or not surgically sterile \[absence of ovaries and/or uterus\]) must have negative serum/urine pregnancy tests during Screening and Week -4; subjects must agree to use 2 reliable forms of contraception during the trial, one of which is recommended to be hormonal, such as an oral contraceptive. Hormonal contraception must be started ≥1 full cycle prior to Week -4 (start of MTX) and continue for 4 weeks/30 days after the last dose of pegloticase, or at least one ovulatory cycle after the last dose of MTX (whichever is the longest duration after the last dose of pegloticase or MTX). Highly effective contraceptive methods (with a failure rate \<1% per year), when used consistently and correctly, include implants, injectables, combined oral contraceptives, some intrauterine devices, sexual abstinence, or vasectomized partner.
What they're measuring
1
Proportion of Serum Uric Acid (sUA) Responders (sUA < 6 mg/dL) During Month 6
Timeframe: Month 6 (Weeks 20, 21, 22, 23, and 24)
2
Time to first sUA ≥6 mg/dL after first achieving sUA <6 mg/dL, from the first pegloticase infusion until Week 24
✓. Men who are not vasectomized must agree to use appropriate contraception so as to not impregnate a female partner of reproductive potential during the trial, beginning with the initiation of MTX at Week -4 and continuing and for at least 3 months after the last dose of MTX.
✓. Able to tolerate MTX 15 mg orally for 4 weeks (Week -4 through Day 1) prior to enrollment.
Exclusion criteria
✕. Weight \>160 kg (352 pounds) at Screening.
✕. Any serious acute bacterial infection, unless treated and completely resolved with antibiotics at least 2 weeks prior to the Day 1 Visit.
✕. 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 (3 months or longer) would also meet exclusion criteria.
✕. History of any transplant surgery requiring maintenance immunosuppressive therapy.
✕. Known history of hepatitis B virus surface antigen positivity or hepatitis B DNA positivity.
✕. Known history of hepatitis C virus RNA positivity, unless treated and viral load is negative.
✕. Known history of Human Immunodeficiency Virus (HIV) positivity.