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Acute GoutPhase 2NCT00798369

Targeted Dose Finding of Canakinumab (ACZ885) for Management of Acute Flare in Refractory or Contraindicated Gout Patients

A Phase 2 study testing Canakinumab and Triamcinolone acetonide in people with Acute Gout, run by Novartis at 75 sites in 11 countries.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
Search all trials

Trial summary

This 8-week study is designed to determine the target dose of canakinumab (ACZ885) for the management of acute flare in gout patients who are contraindicated to Non-Steroidal anti-inflammatory drugs and/or colchicine. The efficacy of ACZ885 will be compared to the corticosteroid triamcinolone acetonide. Read more about this study

Who is it for?
Ages 18 to 80 years
Conditions the study is for
Acute Gout
What is being tested?
Canakinumab and Triamcinolone acetonide
Type of treatment
Injection or infusion
Could I receive a placebo?
No, everyone receives an active treatment
How many people
200 participants
Where
75 sitesin 11 countries
Study dates
Nov 2008to Aug 2009
Phase
Phase 2
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 80 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • History of at least 1 gout flare prior to the Screening Visit
  • Meeting the American College of Rheumatology (ACR) 1977 preliminary criteria for the classification of acute arthritis of primary gout.
  • Presence of acute gout flare for no longer than 5 days.
  • Baseline pain intensity > or = to 50 mm on the 0-100 mm VAS.
  • Contraindicated for, intolerant or unresponsive to NSAIDs, colchicine or both.

Who cannot join

  • Rheumatoid arthritis, evidence/suspicion of infectious/septic arthritis, or other acute inflammatory arthritis.
  • Presence of severe renal function impairment
  • Contraindication to intramuscular injection
  • Known presence or suspicion of active or recurrent bacterial, fungal or viral infection at the time of enrollment
  • Evidence of active pulmonary disease
  • Live vaccinations within 3 months prior to the start of the study
  • Use of forbidden therapy
  • Other protocol-defined inclusion/exclusion criteria applied

Trial locations and contacts

75 sites in 11 countries.

75 sites in 11 countries

United States27 sites
  • New Mexico Clinical Research & Osteoporosis Center, Inc.

    Albuquerque, New Mexico, 87106

  • Pinnacle Research Group, LLC

    Anniston, Alabama, 36207-5710

  • Billings Clinic Research Center

    Billings, Montana, 59101

  • Regional Clinical Research Rheumatology Assoc.

    Binghamton, New York, 13905

  • University of Alabama at Birmingham

    Birmingham, Alabama, 35294

  • Intermountain Orthopedics

    Boise, Idaho, 83702

  • Northwest Clinical Trials

    Boise, Idaho, 83704

  • Associated Pharmaceutical Research

    Buena Park, California, 90620

  • Altoona Center for Clinical Research

    Duncansville, Pennsylvania, 16635

  • Comprehensive Rheumatology

    Hendersonville, Tennessee, 37075

  • MultiSpecialty Clinical Research

    Johnson City, Tennessee, 37601

  • Southwest Rheumatology

    Mesquite, Texas, 75150

  • Integrity Clinical Research, LLC

    Milan, Tennessee, 38358

  • Montana Medical Research

    Missoula, Montana, 59804

  • Arthritis and Diabetes Clinic

    Monroe, Louisiana, 71203

  • Health Research of Hampton Roads

    Newport News, Virginia, 23606

  • Northern California Institute for Bone Health

    Oakland, California, 94609

  • Heartland Clinical Research, Inc.

    Omaha, Nebraska, 68134

  • Harbin Clinic

    Rome, Georgia, 30165

  • San Diego Arthritis & Osteoporosis Medical Clinic

    San Diego, California, 92108

  • The Arthritis Center

    Springfield, Illinois, 62704

  • Arthritis Consultants, Inc.

    St Louis, Missouri, 63141

  • Tampa Medical Group, P.A.

    Tampa, Florida, 33614

  • Cotton O'Neil Clinic

    Topeka, Kansas, 66606

  • Community Research Partners, Inc.

    Varnville, South Carolina, 29944

  • Center for Clinical Trials of San Gabriel

    West Covina, California, 91790

  • Florida Medical Clinic, PA

    Zephyrhills, Florida, 33542

Other trials in United States

Germany16 sites
  • Novartis Investigative Site

    Bad Nauheim

  • Novartis Investigative Site

    Bautzen

  • Novartis Investigative Site

    Berlin

  • Novartis Investigative Site

    Chemnitz

  • Novartis Investigative Site

    Dachau

  • Novartis Investigative Site

    Dresden

  • Novartis Investigative Site

    Frankfurt

  • Novartis Investigative Site

    Georgensgmünd

  • Novartis Investigative Site

    Hamburg

  • Novartis Investigative Site

    Leipzig

  • Novartis Investigative Site

    Löhne

  • Novartis Investigative Site

    Magdeburg

  • Novartis Investigative Site

    Messkirch

  • Novartis Investigative Site

    Munich

  • Novartis Investigative Site

    Schwabach

  • Novartis Investigative Site

    Zerbst

Other trials in Germany

Turkey (Türkiye)9 sites
  • Novartis Investigative Site

    Adana

  • Novartis Investigative Site

    Ankara

  • Novartis Investigative Site

    Antalya

  • Novartis Investigative Site

    Aydin

  • Novartis Investigative Site

    Gaziantep

  • Novartis Investigative Site

    Istanbul

  • Novartis Investigative Site

    Izmir

  • Novartis Investigative Site

    Manisa

  • Novartis Investigative site

    Sihhiye/Ankara

Other trials in Turkey (Türkiye)

Russia6 sites
  • Novartis Investigative site

    Chelyabinsk

  • Novartis Investigative Site

    Moscow

  • Novartis Investigative Site

    Saint Petersburg

  • Novartis Investigative site

    Tyumen

  • Novartis Investigative Site

    Yaroslavl

  • Novartis Investigative site

    Yekaterinburg

Other trials in Russia

Switzerland4 sites
  • Novartis Investigative site

    Baden

  • Novartis Investigative site

    Basel

  • Novartis Investigative site

    Bern

  • Novartis Investigative site

    Lausanne

Other trials in Switzerland

United Kingdom4 sites
  • Novartis Investigative Site

    Antrim

  • Novartis Investigative Site

    Coventry

  • Novartis Investigative Site

    Lancashire

  • Novartis Investigative Site

    Wellingborough

Other trials in United Kingdom

Canada3 sites
  • Novartis Investigative site

    Moncton

  • Novartis Investigative site

    Mount Pearl

  • Novartis Investigative site

    St. John's

Other trials in Canada

Poland3 sites
  • Novartis Investigative site

    Poznan

  • Novartis Investigative site

    Szczecin

  • Novartis Investigative site

    Wroclaw

Other trials in Poland

Argentina1 site
  • Novartis Investigative site

    Rosario

Other trials in Argentina

Belgium1 site
  • Novartis Investigative site

    Gozée

Other trials in Belgium

France1 site
  • Novartis Investigative site

    Paris

Other trials in France

About this study

Official title: An Adaptive Dose-ranging, Multi-center, Single-blind, Double-dummy, Active-controlled Trial to Determine the Target Dose of Canakinumab (ACZ885) in the Treatment of Acute Flares in Gout Patients Who Are Refractory or Contraindicated to NSAIDs and/or Colchicine

This 8-week study is designed to determine the target dose of canakinumab (ACZ885) for the management of acute flare in gout patients who are contraindicated to Non-Steroidal anti-inflammatory drugs and/or colchicine. The efficacy of ACZ885 will be compared to the corticosteroid triamcinolone acetonide.

Conditions
Acute Gout
Being tested
Canakinumab, Triamcinolone acetonide
Keywords
Acute flares, Gout, Anti-interleukin-1β monoclonal antibody, Colchicine, Triamcinolone acetonide
Medical subject headings
Gout

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • CanakinumabDrug

    Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1. The i.m. injection was recommended to be administered deeply into the gluteal muscle.

  • CanakinumabDrug

    Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1.

  • CanakinumabDrug

    Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1.

  • CanakinumabDrug

    Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1.

  • CanakinumabDrug

    Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1.

  • Triamcinolone acetonideDrug

    Randomized patients received triamcinolone acetonide 40 mg i.m. once and placebo matching canakinumab s.c. once, on Day 1.

Study groups in NCT00798369
Study groupRoleWhat they receive
Canakinumab 10 mgExperimentalCanakinumab 10 mg subcutaneous (s.c) once. The s.c. injection could be administered into the arm or thigh. Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1. The i.m. injection was recommended to be administered deeply into the gluteal muscle.
Receives: Drug: Canakinumab
Canakinumab 25 mgExperimentalCanakinumab 25 mg subcutaneous (s.c) once. The s.c. injection could be administered into the arm or thigh. Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1. The i.m. injection was recommended to be administered deeply into the gluteal muscle.
Receives: Drug: Canakinumab
Canakinumab 50 mgExperimentalCanakinumab 50 mg subcutaneous (s.c) once. The s.c. injection could be administered into the arm or thigh. Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1. The i.m. injection was recommended to be administered deeply into the gluteal muscle.
Receives: Drug: Canakinumab
Canakinumab 90 mgExperimentalCanakinumab 90 mg subcutaneous (s.c) once. The s.c. injection could be administered into the arm or thigh. Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1. The i.m. injection was recommended to be administered deeply into the gluteal muscle.
Receives: Drug: Canakinumab
Canakinumab 150 mgExperimentalCanakinumab 150 mg subcutaneous (s.c) once. The s.c. injection could be administered into the arm or thigh. Randomized patients received one s.c. injection of canakinumab and placebo matching triamcinolone acetonide (0.9% sodium chloride) intramuscularly (i.m.) once, on Day 1. The i.m. injection was recommended to be administered deeply into the gluteal muscle.
Receives: Drug: Canakinumab
Triamcinolone acetonide 40 mgActive comparatorTriamcinolone acetonide 40 mg intramuscularly (i.m) once. The i.m. injection was recommended to be administered deeply into the gluteal muscle. Randomized patients received triamcinolone acetonide 40 mg i.m. once and placebo matching canakinumab s.c. once, on Day 1.
Receives: Drug: Triamcinolone acetonide

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. The Dose of Canakinumab for Treatment of Acute Flares in Gout Patients That Leads to the Same Efficacy as Triamcinolone Acetonide With Respect to Pain Intensity on a 0-100 mm Visual Analog Scale (VAS)

    Mean target dose at 24, 48 and 72 hours. Four models: Emax, Logistic, Linear in log-dose, Linear were selected to describe the potential dose-response curve and hence estimate the target dose of canakinumab using baseline Visual Analog Scale (VAS) and Body Mass Index (BMI) as covariates. Target dose was defined as the dose for which the efficacy is equivalent to the efficacy of triamcinolone acetonide 40 mg and was identified by assessing the dose response relationship with regards to the pain intensity in the target joint measured on a 0- 100 mm VAS (0= no pain and 100= unbearable pain).

    Measured: at 24,48 and 72 hours post-baseline

Secondary outcomes (6)
  1. The Change in Pain Intensity in the Target Joint Following Canakinumab Administration Compared to Triamcinolone Acetonide

    The change in pain intensity from baseline to 72 hours and 7 days post dose as measured on a 0-100 mm Visual Analog Scale(VAS): 0= no pain and 100= severe pain. Analysis of Covariance (ANCOVA) with treatment group, VAS at baseline and Body mass Index (BMI) at baseline as covariates. Change from baseline = (post-baseline measurement - baseline).

    Measured: Baseline,at 72 hrs post-dose and 7 days post-dose

  2. Percentage of Participants With an Excellent or Good Response With Regards to the Patient's Global Assessment of Response to Treatment

    Participants scored their global assessment of response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Slight and Poor.

    Measured: at 72 hours post-baseline

  3. The Time to 50% Reduction of Baseline Pain Intensity in the Target Joint

    The median time in days to at least 50% reduction in Pain intensity from baseline as measured by Visual Analog Scale (VAS) for each treatment group. Participants scored their pain intensity in the target joint on a 0-100 mm VAS, ranging from no pain (0) to unbearable pain (100).

    Measured: Baseline, within 7 days after randomization

  4. High Sensitivity C-reactive Protein (hsCRP) at 72 Hours, 7days, 4 Weeks and 8 Weeks Post Dose for Each Treatment Group

    High sensitivity C-reactive protein (hsCRP) was determined in serum at all visits (Visits 1-5) in order to identify the presence of inflammation, to determine its severity, and to monitor response to treatment.

    ANCOVA with treatment group, protein level at baseline and BMI at baseline as covariates.

    Measured: at 72 hours and 7 days, 4 and 8 weeks post-dose

  5. Serum Amyloid Protein (SAA) Levels at 72 Hours, 7days, 4 Weeks and 8 Weeks Post Dose for Each Treatment Group

    Serum amyloid A (SAA) were determined in serum at all visits (Visits 1-5) in order to identify the presence of inflammation, to determine its severity, and to monitor response to treatment.

    ANCOVA with treatment group, protein level at baseline and BMI at baseline as covariates.

    Measured: at 72 hours and 7 days, 4 and 8 weeks post-dose

  6. Amount of Rescue Medication Taken for Each Treatment Group

    Participants who had difficulty in tolerating their pain after the 6-hour post-dose pain assessments and during the first 7 study days were allowed to take a maximum of 30 mg prednisolone (or equivalent dose of prednisone [30 mg]) orally once a day for a maximum of 5 days. In addition, participants could use 500 mg acetaminophen (paracetamol) and/or 30 mg codeine as needed during the first 7 study days. A maximum of 1 g/dose or 3 g/day of acetaminophen and 30 mg/dose or 180 mg/day of codeine was allowed during the first 7 days of the study.

    Measured: 7 days after study drug administration

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted26 Nov 2008 (estimated)
  2. Study startNov 2008
  3. Primary completionAug 2009
  4. Study completionAug 2009

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT00798369
Sponsor's protocol ID
CACZ885H2255
Other IDs
EudraCT 2008-004666-61
Status last verified
Apr 2012
First submitted
25 Nov 2008
Last updated
10 Apr 2012

Publications

  • Chakraborty A, Van LM, Skerjanec A, Floch D, Klein UR, Krammer G, Sunkara G, Howard D. Pharmacokinetic and pharmacodynamic properties of canakinumab in patients with gouty arthritis. J Clin Pharmacol. 2013 Dec;53(12):1240-51. doi: 10.1002/jcph.162. Epub 2013 Sep 30.

    PubMed 24122883
  • Schlesinger N, De Meulemeester M, Pikhlak A, Yucel AE, Richard D, Murphy V, Arulmani U, Sallstig P, So A. Canakinumab relieves symptoms of acute flares and improves health-related quality of life in patients with difficult-to-treat Gouty Arthritis by suppressing inflammation: results of a randomized, dose-ranging study. Arthritis Res Ther. 2011 Mar 25;13(2):R53. doi: 10.1186/ar3297.

    PubMed 21439048
  • So A, De Meulemeester M, Pikhlak A, Yucel AE, Richard D, Murphy V, Arulmani U, Sallstig P, Schlesinger N. Canakinumab for the treatment of acute flares in difficult-to-treat gouty arthritis: Results of a multicenter, phase II, dose-ranging study. Arthritis Rheum. 2010 Oct;62(10):3064-76. doi: 10.1002/art.27600.

    PubMed 20533546

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Canakinumab and Triamcinolone acetonide in people with Acute Gout, run by Novartis at 75 sites in 11 countries.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 10 Apr 2012. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 75 sites in United States, Germany, Turkey (Türkiye), Russia, Switzerland and 6 more countries. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Yes. Results are posted in the registry (first posted 16 May 2011). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

The Dose of Canakinumab for Treatment of Acute Flares in Gout Patients That Leads to the Same Efficacy as Triamcinolone Acetonide With Respect to Pain Intensity on a 0-100 mm Visual Analog Scale (VAS) (time frame: at 24,48 and 72 hours post-baseline). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT00798369, which also lists 3 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 10 Apr 2012; AzTrials last refreshed its copy on 8 Nov 2026.

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