Gout Clinical Trial
Official title:
A Multicenter, Randomized, Double Blind, Placebo Controlled, Parallel Group, 1 Week, Dose Comparison Study to Evaluate the Efficacy, Safety, and Tolerability of MPC-004 in Patients With an Acute Gout Flare
This study is a multicenter, randomized, double-blind, placebo-controlled, parallel group, dose-comparison to determine the efficacy and safety of a standard-dose of colchicine (4.8 mg) versus low-dose colchicine (1.8 mg) or placebo for acute gout flares.
This study is a multi-center, randomized, double-blind, placebo-controlled, parallel group
trial to compare the efficacy and safety of standard-dose colchicine (STD)(total dose = 4.8
mg) versus low-dose colchicine (total dose 1.8 mg) or placebo for the treatment of acute
gout flares. Eight hundred and thirteen patients with a confirmed diagnosis of gout were
screened. 238 of the screened patients failed screening; 235(98.7%) failed because they did
not meet inclusion/exclusion criteria. The 575 eligible patients were randomly assigned
(1:1:1) to one of three treatment groups . At the randomization visit the investigator
dispensed a blister card containing eight identical looking capsules (in a combination of
active drug and placebo capsules) in a double blind fashion for use during their next gout
flare. Patients were instructed to self-initiate treatment with the study medication within
12 hours of a gout flare onset. Gout flares were determined by calling a Gout Flare Call
Center established for this purpose. At Investigator discretion, rescue medication could
also be provided, but patients were encouraged not to use rescue medication within the first
24 hours after starting treatment with study drug. Of the 575 study participants, 185 had a
qualifying gout flare and 390 did not. Patients used a diary to record study drug
administration, pain score, the presence or absence of gastrointestinal adverse events
(nausea, vomiting, diarrhea, and abdominal pain) and the timing of any rescue medication use
prior to beginning treatment and 1, 2, 3, 4, 5, 6, 7, 8, 16, 24, 32, 40, 48, 56, 64, and 72
hours after the start of dosing.
The pain score was based on a scale of 1 - 10 where 1 was no pain and 10 was the worst pain
imaginable. Efficacy was defined as a 50% reduction in pain score in the target joint at 24
hours in patients who did not use rescue medicine. The primary efficacy analysis was to be
based on an Intent-to-Treat (ITT) population, defined as all patients who were randomized,
contacted the Call Center, and were instructed to begin taking study drug. An otherwise
qualified patient was excluded from the ITT population only if the patient returned a study
drug blister pack completely unused.
Secondary outcome measures compared the efficacy of STD dose colchicine to a low dose
regimen and placebo using the same criteria for efficacy as for the primary outcome measure.
Additional secondary outcome measures were time to 50% and 90% reduction in pain in the
target joint analyzed by treatment group using Kaplan-Meier methods, and the change in mean
pain intensity from 0 to 72 hours plotted by time point for each treatment group.
All safety analyses were carried out using the safety population defined as all patients who
received at least one dose of study medication regardless of authorization by the Call
Center To determine the safety of colchicine when administered via two different dose
regimens all patients who had a gout flare were seen by the investigator as soon as possible
after onset and evaluated until the flare and any adverse events resolved. All adverse
effects, whether recorded by the patient in the diary or obtained by systematic evaluation
by the investigator were recorded and reported in tabular form. Treatment-emergent adverse
events (TEAE) were summarized by MedDRA System Organ Class and preferred terms and tabulated
according treatment arm, overall incidence, severity and relationship to study medication.
Multiple events within a patient were counted once and at greatest severity and closest
relationship to study medication.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment
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