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MPC-004 for the Treatment of an Acute Gout Flare

Information source: Takeda
ClinicalTrials.gov processed this data on August 23, 2015
Link to the current ClinicalTrials.gov record.

Condition(s) targeted: Gout

Intervention: High Dose Colchicine (4.8 mg total dose) (Drug); Low Dose Colchicine (1.8mg total dose) (Drug); Placebo Control (Other)

Phase: Phase 3

Status: Completed

Sponsored by: Takeda

Official(s) and/or principal investigator(s):
Matthew W Davis, MD, RPh, Study Chair, Affiliation: AR Scientific, Inc.


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.

Clinical Details

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

Study design: Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator), Primary Purpose: Treatment

Primary outcome: Responders

Detailed description: 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.


Minimum age: 18 Years. Maximum age: N/A. Gender(s): Both.


Inclusion Criteria: 1. Patients of either gender and of any race ≥18 years of age. 2. If female, patients must be postmenopausal as evidenced by lack of menses for ≥12 consecutive months. 3. Patients must present with a confirmed diagnosis of gout. 4. Patients must have experienced ≥2 acute gouty arthritic attacks in the 12 months prior to randomization. 5. Patients on urate lowering therapy must be on a stable dose and schedule with no changes in therapy for 4 weeks prior to randomization and expected to remain on a stable regimen during study participation. 6. Patients must be willing to adhere to the study schedule and the protocol requirements. 7. Patients must be willing and able to give written informed consent. A HIPAA and/or state privacy consent must also be signed. Exclusion Criteria: 1. Patients with acute polyarticular gout (>4 joints). 2. Patients who have experienced >2 acute gouty arthritic attacks per month, or >12 attacks overall, in the 6 months prior to randomization. 3. Patients with arthritis due to any cause other than gout that may confound any study assessments per Investigator discretion. 4. Patients with a history of myocardial infarction, unstable angina, cerebrovascular events, or coronary artery bypass grafting within the previous 6 months prior to screening. 5. Patients with active myeloid leukemia, obstructive gastrointestinal cancer, or metastatic cancer. 6. Patients with chronic renal dysfunction (creatinine clearance <60 mL/min as estimated with the Cockcroft Gault formula). 7. Patients with chronic hepatic dysfunction. 8. Patients with a history of alcohol or substance abuse within the 12 months prior to randomization. 9. Patients who have any concomitant illness or other finding that, in the opinion of the Investigator, would confound the study data or place the patient at unacceptable risk if the patient were to participate in the study, or that would require frequent adjustments in concomitant medications during the course of the study. 10. Patients using systemic corticosteroid, cyclosporine, adalimumab, etanercept, infliximab, anakinra, abatacept, mycophenolate, azathioprine, anticoagulants (warfarin, heparin, low molecular weight heparin [LMWH], antithrombin agents, thrombin inhibitors, or selective Factor Xa inhibitors [note, use of aspirin ≤325 mg/day is allowed]), or chronic use of non steroidal anti inflammatory drugs (NSAIDs), acetaminophen, tramadol, and other analgesics such as opiates at screening 11. Use of any investigational drug within 30 days prior to randomization. 12. Patients currently participating in another research study or anticipated to enroll in such during participation in this study. 13. Patients for whom informed consent cannot be obtained. 14. Patients who have previously been randomized into this study and begun ingestion of study drug.

Locations and Contacts

Birmingham, Alabama, United States

Innovative Clinical Trials, Birmingham, Alabama 35205, United States

Tomac, Inc., Columbiana, Alabama 35051, United States

Rheumatology Associates of North Alabama, Huntsville, Alabama 35801, United States

Tucson, Arizona, United States

Genova Clinical Research, Tucson, Arizona 85741, United States

NEA Clinic, Jonesboro, Arkansas 72401, United States

Arkansas Primary Care Clinic, Little Rock, Arkansas 72204, United States

Irvine Center for Clinical Research, Irvine, California 92618, United States

La Jolla, California, United States

Paramount, California, United States

Rancho Cucamonga Clinical Trials, Rancho Cucamonga, California 91730, United States

San Diego, California, United States

West Covina, California, United States

Florida Medical Center, Clearwater, Florida 33755, United States

Nature Coast Clinical Research, Crystal River, Florida 34429, United States

Southeastern Integrated Medical, Gainesville, Florida 32607, United States

George E. Platt, MD, Green Cove Springs, Florida 32043, United States

Jacksonville Center for Clinical Research, Jacksonville, Florida 32216, United States

Health Awareness, Inc., Jupiter, Florida 33458, United States

Lake Mary, Florida, United States

Medical Research Trust, Lake Worth, Florida 33461, United States

Hillcrest Medical Center, Orange City, Florida 32763, United States

Farmer MD, PA, Ormond Beach, Florida 32174, United States

Coastal Medical Research, Inc., Port Orange, Florida 32127, United States

Southwest Florida Clinical Research Center, Tampa, Florida 33609, United States

Geodessey Research, LLC, Vero Beach, Florida 32960, United States

Bond Clinic, Winter Haven, Florida 33880, United States

Global Research Partners & Consultants, Inc., Calhoun, Georgia 30701, United States

Decatur, Georgia, United States

North Georgia Rheumatology Group, PC, Lawrenceville, Georgia 30045, United States

Arthritis & Osteoporosis Center of South Georgia, Tifton, Georgia 31794, United States

Boise, Idaho, United States

Idaho Arthritis & Osteoporosis Center, Meridian, Idaho 83642, United States

Lake County Research Associates, Libertyville, Illinois 60048, United States

Moline, Illinois, United States

Physicians Clinic of Iowa, Cedar Rapids, Iowa 52401, United States

The Center for Arthritis & Osteoporosis, Elizabethtown, Kentucky 42701, United States

David H. Neustadt PSCq, Louisville, Kentucky 40202, United States

Gulf Coast Research, Baton Rouge, Louisiana 70808, United States

Arthritis and Osteoporosis Center of Maryland, Frederick, Maryland 21702, United States

Rockville, Maryland, United States

The Center for Rheumatology & Bone Research, Wheaton, Maryland 20902, United States

Future Care Studies, Springfield, Massachusetts 01103, United States

Clinical Pharmacology Study Group, Worcester, Massachusetts 01610, United States

Justus Fiechtner, MD, MPH, Lansing, Michigan 48910, United States

Arthritis Associates, Hattiesburg, Mississippi 39402, United States

Medical Center Healthcare Research, Florissant, Missouri 63031, United States

Medex Healthcare, Saint Louis, Missouri 63117, United States

Las Vegas, Nevada, United States

Arthritis Center of Reno, Reno, Nevada 89502, United States

Arthritis & Osteoporisis Associates, Manalapan, New Jersey 07726, United States

Rheumatology and Arthritis Associates, Medford, New Jersey 08055, United States

Voorhees, New Jersey, United States

Albany, New York, United States

Southwest Medical Associates, Brewster, New York 10509, United States

Concorde medical Group, New York, New York, United States

Rochester, New York, United States

Syracuse, New York, United States

Williamsville, New York, United States

Arthritis Consultants of the Carolinas, Belmont, North Carolina 28012, United States

Arthritis & Osteoporosis Consultants of the Carolinas, Charlotte, North Carolina 28207, United States

Dayton, Ohio, United States

Mayfield Village, Ohio, United States

Middleburg Heights, Ohio, United States

Duncansville, Pennsylvania, United States

Harleysville, Pennsylvania, United States

Philadelphia, Pennsylvania, United States

Orangeburg, South Carolina, United States

Milan, Tennessee, United States

New Tazewell, Tennessee, United States

Arlington, Texas, United States

Austin, Texas, United States

Carrollton, Texas, United States

Fort Worth, Texas, United States

Houston, Texas, United States

Irving, Texas, United States

San Antonio, Texas, United States

Sugarland, Texas, United States

Ettrick, Virginia, United States

Portsmouth, Virginia, United States

Reston, Virginia, United States

Suffolk, Virginia, United States

Additional Information

Starting date: April 2007
Last updated: October 30, 2012

Page last updated: August 23, 2015

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