Overview

Cardiovascular Safety of Febuxostat and Allopurinol in Participants With Gout and Cardiovascular Comorbidities (CARES)

Status:
Completed
Trial end date:
2017-07-18
Target enrollment:
0
Participant gender:
All
Summary
The purpose of this study is to see whether subjects with gout who receive febuxostat or allopurinol for up to 9 years have a higher rate of serious heart and blood vessel complications (major cardiovascular events).
Phase:
Phase 3
Accepts Healthy Volunteers?
No
Details
Lead Sponsor:
Takeda
Collaborator:
Teijin America, Inc.
Treatments:
Allopurinol
Febuxostat
Uric Acid
Criteria
Inclusion Criteria:

1. The participant or the participant's legally acceptable representative signs and dates
a written, informed consent form/Health Insurance Portability and Accountability Act
(HIPAA) Authorization prior to the initiation of any study procedures.

2. The participant is male ≥50 years of age or female ≥55 years of age and at least
2-years post-menopausal.

3. The participant has a history of major CV or cerebrovascular disease including at
least one of the following:

- Myocardial infarction (MI).

- Hospitalized unstable angina.

- Cardiac or cerebrovascular revascularization procedure.

- Stroke.

- Hospitalized transient ischemic attack (TIA).

- Peripheral vascular disease (ankle brachial index ≤0.6, revascularization and/or
well-documented history of claudication).

- History of diabetes mellitus with evidence of micro- or macrovascular disease
(retinopathy, neuropathy, nephropathy, small vessel vascular diseases).

4. The participant has a history or presence of gout defined as having one or more of the
American Rheumatism Association criteria for the diagnosis of gout:

- A tophus proven to contain urate crystals by chemical or polarized light
microscopic means, and/or

- Characteristic urate crystals in the joint fluid, and/or

- History of at least 6 of the following clinical, laboratory, and X-ray phenomena:

- More than 1 attack of acute arthritis.

- Maximum inflammation developed within 1 day.

- Monoarticular arthritis.

- Redness observed over joints.

- First metatarsophalangeal joint painful or swollen.

- Unilateral first metatarsophalangeal joint attack.

- Unilateral tarsal joint attack.

- Tophus (proven or suspected).

- Hyperuricemia.

- Asymmetric swelling within a joint on x-ray.

- Subcortical cysts without erosions on x-ray.

- Joint fluid culture negative for organisms during attack.

5. The participants must have either:

- a serum urate or serum uric acid (sUA) level ≥7.0 mg/dL (≥416 μmol/L) at the Day
-7 Visit OR

- a sUA level ≥6.0 mg/dL (≥354 μmol/L) at the Day -7 Visit AND inadequately
controlled gout (≥1 flare in the 12 months prior to screening and/or the presence
of tophi).

6. The participant is capable of understanding and complying with protocol requirements

Exclusion Criteria:

Participants who meet any of the following criteria will not qualify for entry into this
study:

1. The participant has secondary hyperuricemia (eg, due to myeloproliferative disorder,
or organ transplant).

2. The participant has a history of xanthinuria.

3. The participant has received urate-lowering therapy (i.e., febuxostat, allopurinol,
probenecid, etc.) or excluded medication during the screening period (beginning with
Day -7).

4. The participant has a known hypersensitivity to febuxostat or allopurinol or any
components of their formulation.

5. The participant has active peptic ulcer disease.

6. The participant has a history of cancer (other than basal cell carcinoma of the skin)
within 5 years prior to the first dose of study medication.

7. The participant had MI or stroke within 60 days prior to the Screening Visit.

8. The participant has alanine aminotransferase (ALT) and/or aspartate aminotransferase
(AST) values greater than 2 times the upper limit of normal (×ULN) during the
Screening period.

9. The participant has a significant medical condition and/or conditions that would
interfere with the treatment, safety, or compliance with the protocol.

10. The participant has a history of drug abuse (defined as any illicit drug use) or a
history of alcohol abuse within 5 years prior to the Screening Visit or the
participant consumes >14 alcoholic beverages per week.

11. The participant has received any investigational medicinal product within the 30 days
prior to the Screening Visit and throughout the study.

12. The participant's estimated creatinine clearance (CLcr) is <30 mL/min, where CLcr is
calculated using the Cockcroft and Gault formula based on ideal body weight (IBW),

13. The participant is an immediate family member, study site employee, or is in a
dependant relationship with a study site employee who is involved in conduct of this
study (eg, spouse, parent, child, sibling) or may consent under duress.

14. The participant is required to take excluded medications

15. The participant has a known history of infection with hepatitis B, hepatitis C, or
human immunodeficiency virus.