- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01112982
An Assessment of Chronic Synovial-Based Inflammation and Its Role With Serum Urate Levels.
July 18, 2019 updated by: University of South Florida
Shifting the Paradigm of Gout: An Assessment of Chronic Synovial-Based Inflammation and Its Role With Serum Urate Levels.
The purpose of this study is to show that patients with gout suffer from chronic inflammation of their joints, observable by MRI, even in the absence of symptomatic gouty attacks.
Secondary end-points of this study will include analyzing the effects of uric acid-lowering therapy (specifically with the FDA approved medication Febuxostat) in a subgroup of patients, checking for the presence of inflammatory markers to see if there is any correlation with the proposed chronic inflammation, and evaluating for other characteristic findings of gout on MRI.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
The clinical history of untreated gout transitions from an acute intermittent arthritis to a chronic inflammatory arthritis.
This tells us that at some point the inflammation associated with gout does not abate.
Our group recently completed an advanced imaging study in patients with early gout that suggested nearly 60% of subjects had synovial pannus during intercritical gout.
This is likely more prevalent in patients with more advanced gout.
The presence of synovial pannus also likely correlates with serum urate levels.
The primary aim of this study will be to determine the percentage of patients with known gout who have evidence of chronic ongoing synovial-based inflammatory disease, determine the degree of this inflammation, and correlate it with their serum urate levels.
Secondary endpoints will include assessments for the presence of other characteristic findings of gout on these MRI (i.e.
erosive changes, intraosseous tophi, soft tissue tophi, joint effusion, bone marrow edema, and soft tissue edema).
We will also be checking serum high-sensitivity CRP levels to evaluate for any correlation with synovial pannus, and assess baseline radiographs of the "index" joint for the presence of erosive changes, which will be correlated with the presence and severity of synovial pannus in that same joint.
Analysis will also be performed to see if there is a correlation with serum urate levels.
A sub-study will be performed assessing the effect of aggressive serum urate lowering therapy (specifically with febuxostat [Uloric]) on this chronic inflammation; i.e. synovial pannus.
Study Type
Interventional
Enrollment (Actual)
74
Phase
- Phase 4
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
-
-
Florida
-
Tampa, Florida, United States, 33612-4742
- University of South Florida Medical Clinics
-
-
Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
18 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Age > or = 18 - Open ended to both males and females.
- Have a known history of gout diagnosed by current or previous documentation of intracellular MSU crystals in synovial fluid, a tophus proved to contain MSU crystals, or at least six of the twelve ACR diagnostic criteria for gout (see appendix with the 12 diagnostic criteria of gout).
- English of Spanish speaking
- Able to give informed consent
Exclusion Criteria:
- Age < 18.
- Unable to give informed consent.
- Do not speak or write in English or Spanish.
- History of any other inflammatory arthritis.
- History of another crystal induced arthritis.
- Serum creatinine >1.8 mg/dL
- Patients taking oral corticosteroids (any dose) [or within 4 weeks]
- Parenteral or intraarticular corticosteroids within 6 weeks
- Allergy to gadolinium contrast dye
- Any contraindication to receiving a MRI
- Pregnant women
- Allergy to febuxostat (Uloric) or colchicine [substudy subjects only]
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: Non-Randomized
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Other: Febuxostat Sub-Study
To analyze the effect of urate-lowering therapy (specifically with febuxostat [Uloric]) on the synovial pannus in the "index joint" of a subgroup of patients.
Subjects not currently on any urate-lowering therapy, or on a serum urate lowering drug other than febuxostat (Uloric) and who have a serum urate level of > or = to 9.0, will be treated with febuxostat (Uloric) and their serum urate level will be followed at months 1, 3, 6, and 9. Magnetic Resonance Imaging (with and without gadolinium) of the same "index joint" will be repeated at month 9 to assess for the presence and degree of synovial pannus.
Because initiation of urate-lowering therapy can induce acute attacks of gout, these subjects will also be started on colchicine as a prophylactic (and remain on colchicine for 6 months).
|
An Magnetic Resonance Imaging (with and without gadolinium contrast) of index joint will be performed (T1, T2, and STIR images).
Other Names:
All subjects in the sub-study will be started on febuxostat 40mg daily at baseline.
If their serum urate level is > 6.0 at months 1 or 3, then the febuxostat dose will be increased to 80mg daily.
Other Names:
Colchicine will be dosed at 0.6mg by mouth BID for the first three months then 0.6mg daily from months 3 to 6, and then discontinued at month 6.
Other Names:
|
Other: MRI of index joint
To analyze synovial pannus in the Magnetic Resonance Imaging (with and without gadolinium) of the "index joint" on Subjects not currently on any urate-lowering therapy, or on a serum urate lowering drug other than febuxostat (Uloric).
|
An Magnetic Resonance Imaging (with and without gadolinium contrast) of index joint will be performed (T1, T2, and STIR images).
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number and Percentage of Participants With Evidence of Chronic Ongoing Synovial-Based Inflammatory Disease at Baseline.
Time Frame: MRI and baseline uric acid level will be performed upon enrollment in the study.
|
The primary aim of this study will be to determine the percentage of patients with known gout who have evidence of chronic ongoing synovial-based inflammatory disease, i.e. synovial pannus, in their "index joint", and determine if there is a correlation of the prevalence and severity of synovial pannus in the "index joint" with the patients' serum urate levels on the day of their MRI.
|
MRI and baseline uric acid level will be performed upon enrollment in the study.
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Number and Percentage of Substudy Participants for Whom the Severity of Synovial Pannus Was Significantly Reduced After 9 Months of Treatment With Febuxostat (Uloric).
Time Frame: Upon enrollment into study, and at month 9.
|
A sub-study in a subgroup of patients will analyze the Number and Percentage of Substudy Participants for whom the Severity of Synovial Pannus was Significantly Reduced After 9 Months of Treatment with Febuxostat (Uloric) in the "index joint" by comparing the baseline MRI with a repeat MRI of the same joint.
|
Upon enrollment into study, and at month 9.
|
Number of Participants With Other Characteristic Findings of Gout on MRI's Correlated With Serum Urate Levels.
Time Frame: Upon enrollment into study
|
Number of Participants with Other Characteristic Findings of Gout on these MRI's.
These include erosive changes, intraosseous tophi, soft tissue tophi, joint effusion, bone marrow edema, and soft tissue edema.
These secondary endpoints will also be summed with patients' serum urate levels.
|
Upon enrollment into study
|
Mean Serum Urate Levels for Previous 2 Years at Baseline.
Time Frame: previous 2 years upon enrollment into study
|
Determine if there is a correlation between the prevalence and severity of synovial pannus in the "index joint" with the patients' mean serum urate level from the previous 2 years at baseline.
|
previous 2 years upon enrollment into study
|
The Severity of Synovial Pannus the Day of Serum High-sensitivity C-Reactive Protein and Magnetic Resonance Imaging
Time Frame: Upon enrollment into study at screening.
|
Determine if the Number of Participants Prevalence and Severity of Synovial Pannus in the "Index Joint" with the patient's serum high-sensitivity C-Reactive Protein on the same day as the Magnetic Resonance Imaging.
The Magnetic Resonance Imaging will be assessed for the severity of synovial pannus, which is graded on a scale of 1 to 6 (with 6 being the most severe).
|
Upon enrollment into study at screening.
|
Presence or Absence of Erosive Changes on Baseline Radiographs of the "Index" Joint Correlated With the Presence and Severity of Synovial Pannus Correlation With Serum Urate Levels and the Presence of Erosions on Their Plain Radiograph.
Time Frame: Upon enrollment into study
|
Baseline radiographs of the "index" joint will also be obtained on the same day as their MRI and assessed for the presence or absence of erosive changes, intraosseous tophi, soft tissue tophi, joint effusion, bone marrow edema, or soft tissue edema.
This will be correlated with the presence and severity of synovial pannus in that same joint.
The analysis will also be performed to see if there is a correlation with serum urate levels and the presence of erosions on their plain radiograph.
|
Upon enrollment into study
|
High-sensitivity C-Reactive Protein Concentrations
Time Frame: Upon enrollment into study at screening.
|
The concentration of serum high-sensitivity C-Reactive Protein at enrollment.
|
Upon enrollment into study at screening.
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
Investigators
- Study Director: Ernesto J Rodriguez, MD, University Of South Florida, Department of Rheumatology
- Principal Investigator: John D Carter, MD, University Of South Florida, Department of Rheumatology
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start
May 1, 2010
Primary Completion (Actual)
December 1, 2014
Study Completion (Actual)
December 1, 2014
Study Registration Dates
First Submitted
April 27, 2010
First Submitted That Met QC Criteria
April 28, 2010
First Posted (Estimate)
April 29, 2010
Study Record Updates
Last Update Posted (Actual)
August 7, 2019
Last Update Submitted That Met QC Criteria
July 18, 2019
Last Verified
March 1, 2017
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Pro00000136
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
Clinical Trials on Gout
-
Ai PengRecruitingGout Flare | Intercritical Gout | Advanced Gout | Asymptomatic HyperuricemiaChina
-
AmgenCompletedUncontrolled Gout | Chronic GoutUnited States
-
Sheffield Hallam UniversityCherry Research CommitteeUnknown
-
Olatec Therapeutics LLCRecruitingArthritis | Joint Pain | Gout | Gout Flare | Gouty Arthritis | Acute Gout Flare | Gout AttackUnited States, Spain, France
-
GeneScience Pharmaceuticals Co., Ltd.Huashan HospitalNot yet recruitingAcute Gout | Gout Initiating Urico-lowering TherapyChina
-
GeneScience Pharmaceuticals Co., Ltd.Huashan HospitalRecruitingGout Flare | Acute GoutChina
-
AmgenCompletedGout | Chronic Uncontrolled Gout | Uncontrolled GoutUnited States
-
Jiangsu HengRui Medicine Co., Ltd.Not yet recruitingPrimary Gout With Hyperuricemia in Adults
-
Jiangsu HengRui Medicine Co., Ltd.Not yet recruitingPrimary Gout and Hyperuricemia
-
Guangdong Provincial Hospital of Traditional Chinese...RecruitingAcute Pain | Acupuncture | Acute Gout ArthritisChina
Clinical Trials on Magnetic Resonance Imaging
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)Recruiting
-
University of California, San FranciscoTerminatedAnatomic Stage I Breast Cancer AJCC v8 | Anatomic Stage IA Breast Cancer AJCC v8 | Anatomic Stage IB Breast Cancer AJCC v8 | Anatomic Stage II Breast Cancer AJCC v8 | Anatomic Stage IIA Breast Cancer AJCC v8 | Anatomic Stage IIB Breast Cancer AJCC v8 | Anatomic Stage III Breast Cancer AJCC v8 | Anatomic... and other conditionsUnited States
-
M.D. Anderson Cancer CenterNational Cancer Institute (NCI)CompletedHematopoietic and Lymphoid Cell Neoplasm | Malignant Solid NeoplasmUnited States
-
University of MichiganPhilips Healthcare; General ElectricCompleted
-
American College of Radiology Imaging NetworkNational Cancer Institute (NCI)Completed
-
M.D. Anderson Cancer CenterActive, not recruitingProstate Adenocarcinoma | Prostate CarcinomaUnited States
-
Wake Forest University Health SciencesNational Cancer Institute (NCI)CompletedStage IIIA Breast Cancer | Stage IIIB Breast Cancer | Stage IA Breast Cancer | Stage IB Breast Cancer | Stage IIA Breast Cancer | Stage IIB Breast Cancer | Stage IIIC Breast Cancer | Healthy SubjectUnited States
-
Stanford UniversityTerminatedLaryngeal Neoplasms | Head and Neck Cancers | Larynx CancerUnited States
-
Vanderbilt-Ingram Cancer CenterNational Cancer Institute (NCI)CompletedBreast CancerUnited States
-
OHSU Knight Cancer InstituteOregon Health and Science UniversityRecruitingIntracranial NeoplasmUnited States