Trial Outcomes & Findings for The Influence of Febuxostat on Coronary Artery Endothelial Dysfunction in Participants With Chronic Stable Angina (NCT NCT01763996)

NCT ID: NCT01763996

Last Updated: 2016-04-13

Results Overview

Coronary artery flow was measured using magnetic resonance imaging (MRI) at rest and during sustained isometric (static) handgrip exercises. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Recruitment status

COMPLETED

Study phase

PHASE4

Target enrollment

30 participants

Primary outcome timeframe

Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Results posted on

2016-04-13

Participant Flow

Participants took part in the study at one investigative site in the United States from 29 May 2013 (first participant signed the formed consent form) to 14 April 2015.

Participants with a diagnosis of chronic stable angina were enrolled in one of 2 sequence cross-over arms: (1) febuxostat 80 mg for 6 weeks then placebo for 6 weeks, or (2) placebo for 6 weeks then febuxostat 80 mg for 6 weeks.

Participant milestones

Participant milestones
Measure
Sequence 1: Febuxostat 80 mg + Placebo
Febuxostat 80 mg, capsules, orally, once daily for 6 weeks in Period 1, followed by febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 2.
Sequence 2: Placebo + Febuxostat 80 mg
Febuxostat placebo-matching capsules, orally, once daily for 6 weeks in Period 1, followed by febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 2.
Treatment Period 1
STARTED
15
15
Treatment Period 1
COMPLETED
15
15
Treatment Period 1
NOT COMPLETED
0
0
Treatment Period 2
STARTED
15
15
Treatment Period 2
COMPLETED
15
14
Treatment Period 2
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Sequence 1: Febuxostat 80 mg + Placebo
Febuxostat 80 mg, capsules, orally, once daily for 6 weeks in Period 1, followed by febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 2.
Sequence 2: Placebo + Febuxostat 80 mg
Febuxostat placebo-matching capsules, orally, once daily for 6 weeks in Period 1, followed by febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 2.
Treatment Period 2
Adverse Event
0
1

Baseline Characteristics

The Influence of Febuxostat on Coronary Artery Endothelial Dysfunction in Participants With Chronic Stable Angina

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
All Participants
n=30 Participants
All participants who were randomized and received study drug (febuxostat 80 mg and placebo) during the study.
Age, Continuous
59 years
STANDARD_DEVIATION 7.7 • n=5 Participants
Sex: Female, Male
Female
3 Participants
n=5 Participants
Sex: Female, Male
Male
27 Participants
n=5 Participants
Race/Ethnicity, Customized
African-American
5 participants
n=5 Participants
Race/Ethnicity, Customized
White
25 participants
n=5 Participants
Region of Enrollment
United States
30 participants
n=5 Participants
Height
176 cm
STANDARD_DEVIATION 7.7 • n=5 Participants
Weight
87.8 kg
STANDARD_DEVIATION 16 • n=5 Participants
Body Mass Index (BMI)
28.3 kg/m^2
STANDARD_DEVIATION 4.12 • n=5 Participants
Left Ventricular Ejection Fraction
56.8 percent
STANDARD_DEVIATION 9.24 • n=5 Participants

PRIMARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with data available.

Coronary artery flow was measured using magnetic resonance imaging (MRI) at rest and during sustained isometric (static) handgrip exercises. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Placebo
n=29 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=29 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Coronary Artery Flow From Rest to Isometric Handgrip (IHG) Exercise at the End of the Administration of Febuxostat and Placebo
8.8 mL/min
Interval 0.4 to 17.28
10.7 mL/min
Interval 2.23 to 19.11

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with data available.

Coronary artery cross-sectional area was measured by MRI at rest and during sustained isometric (static) handgrip exercise. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Placebo
n=29 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=29 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Coronary Artery Cross-Sectional Area From Rest to IHG Exercise at the End of the Administration of Febuxostat and Placebo
0.45 mm^2
Interval -0.177 to 1.074
0.03 mm^2
Interval -0.595 to 0.656

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with data available.

Coronary flow velocity was measured by MRI at rest and during sustained isometric (static) handgrip exercise. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Placebo
n=29 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=29 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Coronary Flow Velocity From Rest to IHG Exercise at the End of the Administration of Febuxostat and Placebo
1.6 cm/second
Interval -0.1 to 3.4
2.2 cm/second
Interval 0.43 to 3.93

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, who used nitroglycerin.

Coronary artery flow was measured by MRI before and following administration of nitroglycerin under the tongue. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Placebo
n=11 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=15 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Coronary Artery Flow Following the Administration of Sublingual Nitroglycerin at the End of the Administration of Febuxostat and Placebo
17.0 mL/min
Interval -6.0 to 39.98
13.0 mL/min
Interval -2.53 to 28.43

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, who used nitroglycerin.

Coronary artery cross sectional area was measured by MRI before and following administration of nitroglycerin under the tongue. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Placebo
n=11 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=15 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Coronary Artery Cross Sectional Area Following the Administration of Sublingual Nitroglycerin at the End of the Administration of Febuxostat and Placebo
3.35 mm^2
Interval 1.449 to 5.244
2.86 mm^2
Interval 1.582 to 4.138

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, who used nitroglycerin.

Coronary flow velocity was measured by MRI before and following administration of nitroglycerin under the tongue. Data at the end of each treatment period was combined for the febuxostat and the placebo arms. A positive change from Baseline indicates improvement.

Outcome measures

Outcome measures
Measure
Placebo
n=11 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=15 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Coronary Flow Velocity Following the Administration of Sublingual Nitroglycerin at the End of the Administration of Febuxostat and Placebo
-0.95 cm/second
Interval -4.12 to 2.213
-0.66 cm/second
Interval -2.792 to 1.472

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with ischemic ECG changes.

Time in seconds to ischemic ECG changes during ETT. Continuous electrocardiography (ECG) was performed during an exercise treadmill test (modified Bruce protocol) to assess the onset of ST-segment depression after administration of febuxostat or placebo for 6 weeks in participants with a normal ST segment at randomization. . Data at the end of each treatment period was combined for the febuxostat and the placebo arms.

Outcome measures

Outcome measures
Measure
Placebo
n=4 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=2 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Time to Onset of ≥1 mm ST-Segment Depression During Exercise Treadmill Test (ETT)
514 seconds
Standard Deviation 252
316 seconds
Standard Deviation 122

SECONDARY outcome

Timeframe: Baseline and at the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with ST segment change.

Continuous ECG was performed during an exercise treadmill test (modified Bruce protocol) to assess the maximum ST-segment depression after 6 weeks of febuxostat or placebo treatment in participants with a normal ST segment at randomization. A negative change from Baseline indicates improvement. Data at the end of each treatment period was combined for the febuxostat and the placebo arms.

Outcome measures

Outcome measures
Measure
Placebo
n=4 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=2 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Change in Maximum ST-segment Depression During Exercise Treadmill Test
1.3 mm
Standard Deviation 0.5
1.5 mm
Standard Deviation 0.7

SECONDARY outcome

Timeframe: At the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with data available.

An exercise treadmill test (modified Bruce protocol) was performed. Data at the end of each treatment period was combined for the febuxostat and the placebo arms.

Outcome measures

Outcome measures
Measure
Placebo
n=30 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=28 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Percentage of Participants Stopping Exercise Treadmill Test Due to Angina at the End of the Administration of Febuxostat and Placebo
0.0 percentage of participants
3.6 percentage of participants

SECONDARY outcome

Timeframe: At the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with ischemic chest pain.

Time in seconds to ischemic chest pain/ angina during ETT. Data at the end of each period was combined for the febuxostat and the placebo arms

Outcome measures

Outcome measures
Measure
Placebo
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=1 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Time to Onset of Angina During Exercise Treadmill Test at the End of the Administration of Febuxostat and Placebo
330 seconds
Standard Deviation NA
Standard deviation cannot be calculated for 1 participant.

SECONDARY outcome

Timeframe: At the end of each 6 week treatment period (Week 6 and Week 12)

Population: Participants from the Full Analysis Set, all randomized participants who received at least one dose of study drug, with data available.

Exercise duration is the exercise time in seconds during ETT. Data at the end of each period was combined for the febuxostat and the placebo arms.

Outcome measures

Outcome measures
Measure
Placebo
n=30 Participants
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=28 Participants
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Exercise Duration
702 seconds
Interval 682.1 to 721.6
722 seconds
Interval 700.5 to 742.9

Adverse Events

Placebo

Serious events: 0 serious events
Other events: 7 other events
Deaths: 0 deaths

Febuxostat 80 mg

Serious events: 0 serious events
Other events: 6 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
Placebo
n=30 participants at risk
Febuxostat placebo-matching capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Febuxostat 80 mg
n=30 participants at risk
Febuxostat 80 mg, capsules, orally, once daily for up to 6 weeks in Period 1 or 2.
Infections and infestations
Common cold
10.0%
3/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
3.3%
1/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
Nervous system disorders
Headache
3.3%
1/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
6.7%
2/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
Musculoskeletal and connective tissue disorders
Musculoskeletal discomfort
3.3%
1/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
6.7%
2/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
Cardiac disorders
Ventricular extrasystoles
3.3%
1/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
6.7%
2/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
Skin and subcutaneous tissue disorders
Dermatitis contact
6.7%
2/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
0.00%
0/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
General disorders
Fatigue
6.7%
2/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.
0.00%
0/30 • First dose of study drug to up to 30 days after the last dose of study drug (Up to 16 Weeks)
At each visit the investigator had to document any occurrence of adverse events and abnormal laboratory findings. Any event spontaneously reported by the participant or observed by the investigator was recorded, irrespective of the relation to study treatment.

Additional Information

Medical Director, Clinical Science

Takeda

Phone: +1-877-825-3327

Results disclosure agreements

  • Principal investigator is a sponsor employee The first study related publication will be a multi-center publication submitted within 24 months after conclusion or termination of a study at all sites. After such multi site publication, all proposed site publications and presentations will be submitted to sponsor for review 60 days in advance of publication. Site will remove Sponsor confidential information unrelated to study results. Sponsor can delay a proposed publication for another 60 days to preserve intellectual property.
  • Publication restrictions are in place

Restriction type: OTHER