Evaluate the PK, PD, and Safety of Arhalofenate in Combination With Febuxostat for Hyperuricemia in Patients With Gout
A Phase 2, Open-label, Drug-Drug Interaction Study to Evaluate the Pharmacodynamics, Pharmacokinetics, and Safety of Arhalofenate in Combination With Febuxostat for the Treatment of Hyperuricemia in Patients With Gout
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 2
Contacts and Locations
Study Locations
-
-
Kansas
-
Overland Park, Kansas, United States, 66212
- Vince & Associates Clinical Research
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Male or female patient, 18 to 75 years of age, inclusive
- Known gout diagnosis (per criteria of the American Rheumatism Association)
- Has an sUA ≥ 7.5 mg/dL
- A female patient must be surgically sterile or post-menopausal (at least 45 years of age with no history of menses for at least two years), or must agree to use two medically accepted methods of contraception including a barrier method for the entire duration of study participation unless she reports compete sexual abstinence. A female patient must also not be pregnant or lactating
- Estimated creatinine clearance (eCrCl) ≥ 60 ml/min, as calculated by Cockcroft-Gault method
- ALT or AST ≤ 3 times upper limit of normal (ULN) or total bilirubin ≤ 2 times ULN (Gilbert's syndrome is permitted)
- All other clinical laboratory parameters must be within normal limits or considered not clinically significant
- ECG must be normal, or if abnormal, considered not clinically significant
- A patient who is taking a medication or agent (other than a ULT) known to influence sUA levels must be on a stable dose and regimen of the medication for at least two weeks prior to screening and must be willing to continue the same dose and regimen during study participation
- Expected to be able to tolerate a short course of oral NSAIDs and/or oral steroids as may be needed to treat a gout flare
- Must be able to swallow tablets
Exclusion Criteria:
- Treatment with any ULT (e.g., allopurinol, febuxostat, probenecid, or benzbromarone) within two weeks, or pegloticase within six months, prior to the sUA assessment at Day 1
- Occurrence of a gout flare that has not resolved within one week prior to Day 1
- Known or suspected secondary hyperuricemia (e.g., due to myeloproliferative disorder or organ transplant)
- Diagnosis of xanthinuria
- Fractional excretion of urate > 10%
- History of documented or suspected kidney stones within five years prior to screening
- Known infection with the human immunodeficiency virus (HIV) or history of hepatitis B or C
- Recent use/abuse of an illicit drug as determined by a positive urine drug screen
- Uncontrolled hypertension that, in the opinion of the Investigator, would preclude participation in the study
- History of stroke, transient ischemic attack, acute myocardial infarction, congestive heart failure (NYHA class II - IV), angina pectoris, coronary intervention procedure, lower extremity bypass procedure, systemic or intracoronary fibrinolytic therapy within 5 years of screening
- History of cancer within five years of screening, with the following exceptions: adequately treated non-melanoma skin cancer, non-metastatic prostate cancer, or in situ cervical cancer
- Body mass index (BMI) > 42 kg/m2
- Current or expected requirement for anticoagulant therapy, except for low dose (≤ 81 mg/day) aspirin, clopidogrel (Plavix) ≤ 75 mg/day, or prasugrel (Effient) ≤ 10 mg/day
- Use of any of the following within eight weeks prior to screening: potent CYP3A4 inhibitors, cytotoxic agents (including azathioprine, mercaptopurine, cyclosporine, cyclophosphamide, etc.), ranolazine, digoxin, theophylline, sulphonylureas, thiazolidinediones (e.g., rosiglitazone or pioglitazone), desipramine, atypical antipsychotic agents, loop diuretics, warfarin, or phenytoin
- Chronic treatment with NSAIDs that cannot be safely discontinued-term use of NSAIDs is permitted, e.g., when used to treat gout flares
- Known hypersensitivity or intolerance to febuxostat or colchicine
- Treatment with any other investigational therapy within 30 days or within five half-lives, whichever is longer prior to Day 1
- Any other condition that would compromise the safety of the patient, prevent compliance with the study protocol, or compromise the quality of the clinical study, as judged by the Investigator and/or Medical Monitor
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Arhalofenate with febuxostat (PK cohort)
|
800 mg once daily orally for four weeks
40 mg once daily orally for 1 week then up-titrated to 80 mg once daily orally for another three weeks
600 mg once daily orally for four weeks
80 mg once daily orally for 1 week then down-titrated to 40 mg once daily orally for another three weeks
0.6 mg daily
|
|
Experimental: Arhalofenate with febuxostat (non-PK cohort)
|
800 mg once daily orally for four weeks
40 mg once daily orally for 1 week then up-titrated to 80 mg once daily orally for another three weeks
600 mg once daily orally for four weeks
80 mg once daily orally for 1 week then down-titrated to 40 mg once daily orally for another three weeks
0.6 mg daily
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Proportion of patients achieving a target sUA < 6.0, < 5.0, < 4.0, and < 3.0 mg/dL on Day 29 after treatment with arhalofenate 800 mg and febuxostat 80 mg
Time Frame: Day 29
|
Day 29
|
|
Proportion of patients achieving an sUA reduction of ≥ 2.0, ≥ 3.0, and ≥ 4.0 mg/dL from baseline on Day 29 after treatment with arhalofenate 800 mg and febuxostat 80 mg
Time Frame: Day 29
|
Day 29
|
|
Absolute and percent reduction in sUA from baseline on Day 29 after treatment with arhalofenate 800 mg and febuxostat 80 mg
Time Frame: Day 29
|
Day 29
|
|
AUC(0-t) of arhalofenate 800 mg and febuxostat 80 mg when administered separately and in combination
Time Frame: Days 14, 28, and 42
|
Days 14, 28, and 42
|
|
AUC(0-tau) of arhalofenate 800 mg and febuxostat 80 mg when administered separately and in combination
Time Frame: Days 14, 28, and 42
|
Days 14, 28, and 42
|
|
Tmax of arhalofenate 800 mg and febuxostat 80 mg when administered separately and in combination
Time Frame: Days 14, 28, and 42
|
Days 14, 28, and 42
|
|
Cmax of arhalofenate 800 mg and febuxostat 80 mg when administered separately and in combination
Time Frame: Days 14, 28, and 42
|
Days 14, 28, and 42
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Proportion of patients achieving a target sUA < 6.0, < 5.0, < 4.0, and < 3.0 mg/dL on Day 29 after treatment with arhalofenate 600 mg and febuxostat 40 mg
Time Frame: Day 29
|
Day 29
|
|
Proportion of patients achieving an sUA reduction of ≥ 2.0, ≥ 3.0, and ≥ 4.0 mg/dL from baseline on Day 29 after treatment with arhalofenate 600 mg and febuxostat 40 mg
Time Frame: Day 29
|
Day 29
|
|
Absolute and percent reduction in sUA from baseline on Day 29 after treatment with arhalofenate 600 mg and febuxostat 40 mg
Time Frame: Day 29
|
Day 29
|
|
Proportion of patients achieving a target sUA < 6.0, < 5.0, < 4.0, and < 3.0 mg/dL on Day 22 after treatment with arhalofenate 800 mg and febuxostat 40 mg, and with arhalofenate 600 mg and febuxostat 80 mg
Time Frame: Day 22
|
Day 22
|
|
Proportion of patients achieving an sUA reduction of ≥ 2.0, ≥ 3.0, and ≥ 4.0 mg/dL from baseline on Day 22 after treatment with arhalofenate 800 mg and febuxostat 40 mg, and with arhalofenate 600 mg and febuxostat 80 mg
Time Frame: Day 22
|
Day 22
|
|
Absolute and percent reduction in sUA from baseline on Day 22 after treatment with arhalofenate 800 mg and febuxostat 40 mg, and with arhalofenate 600 mg and febuxostat 80 mg
Time Frame: Day 22
|
Day 22
|
|
Proportion of patients achieving a target sUA < 6.0, < 5.0, < 4.0, and < 3.0 mg/dL after monotherapy treatment with arhalofenate 600 or 800 mg, or febuxostat 40 or 80 mg
Time Frame: Day 15 or Day 43
|
Day 15 or Day 43
|
|
Proportion of patients achieving an sUA reduction of ≥ 2.0, ≥ 3.0, and ≥ 4.0 mg/dL from baseline after monotherapy treatment with arhalofenate 600 or 800 mg, or febuxostat 40 or 80 mg
Time Frame: Day 15 or Day 43
|
Day 15 or Day 43
|
|
Absolute and percent reduction in sUA from baseline on Day 15 after monotherapy treatment with arhalofenate 600 or 800 mg
Time Frame: Day 15
|
Day 15
|
|
Absolute and percent reduction in sUA from baseline on Day 43 after monotherapy treatment with febuxostat 40 or 80 mg
Time Frame: Day 43
|
Day 43
|
|
Kel and T1/2 of arhalofenate 800 mg and febuxostat 80 mg, if possible, when administered separately and in combination
Time Frame: Days 14, 28, and 42
|
Days 14, 28, and 42
|
Other Outcome Measures
Other Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Incidence and severity of adverse events (AEs) and serious adverse events (SAEs)
Time Frame: Days 1 through 43
|
Days 1 through 43
|
|
Change in physical examination findings
Time Frame: Days 1 through 43
|
Days 1 through 43
|
|
Change in vital signs and safety laboratory tests
Time Frame: Days 1 through 43
|
Days 1 through 43
|
|
Safety-related study drug discontinuations
Time Frame: Days 1 through 43
|
Days 1 through 43
|
|
Deaths
Time Frame: Days 1 through 43
|
Days 1 through 43
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Alexandra Steinberg, MD, PhD, CymaBay Therapeutics, Inc.
Publications and helpful links
Study record dates
Study Major Dates
Study Start
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Estimate)
First Posted
Study Record Updates
Last Update Posted (Estimate)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Pathologic Processes
- Metabolic Diseases
- Genetic Diseases, Inborn
- Joint Diseases
- Musculoskeletal Diseases
- Rheumatic Diseases
- Arthritis
- Metabolism, Inborn Errors
- Crystal Arthropathies
- Purine-Pyrimidine Metabolism, Inborn Errors
- Hyperuricemia
- Gout
- Molecular Mechanisms of Pharmacological Action
- Antirheumatic Agents
- Antineoplastic Agents
- Tubulin Modulators
- Antimitotic Agents
- Mitosis Modulators
- Gout Suppressants
- Colchicine
- Febuxostat
Other Study ID Numbers
Other Study ID Numbers
- CB102-21426
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