A Trial to Investigate the Non-inferiority of Pegloticase Administered Every 4 Weeks (Q4W) With MTX Compared With Every 2 Weeks (Q2W) With MTX in Participants With Uncontrolled Refractory Gout

NCT ID: NCT06229145

Last Updated: 2026-01-02

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

262 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-18

Study Completion Date

2026-03-12

Brief Summary

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The study consists of 24-week double-blind trial to evaluate the non-inferiority of the efficacy and safety of pegloticase Q4W with MTX versus pegloticase Q2W with MTX, followed by a 24-week open-label extension of pegloticase Q4W with MTX, in participants with uncontrolled refractory gout.

The main objective of the study is to evaluate the effect of pegloticase 16 mg administered Q4W with MTX versus pegloticase 8 mg administered Q2W with MTX, on the response rate during Month 6, as measured by the sustained normalization of sUA to \< 6 mg/dL for at least 80% of the time.

Detailed Description

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Acquired from Horizon in 2024.

Conditions

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Gout

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Investigators

Study Groups

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Pegloticase + Methotrexate Q4W

16 mg pegloticase will be administered intravenously every 4 weeks for 24 weeks during double blind treatment and 24 weeks during open label.

Group Type EXPERIMENTAL

Pegloticase

Intervention Type BIOLOGICAL

IV infusion

Methotrexate

Intervention Type DRUG

Oral

Pegloticase + Methotrexate Q2W

8 mg pegloticase will be administered intravenously every 2 weeks for 24 weeks during double blind treatment and 16 mg pegloticase every 4 weeks for 24 weeks during open label.

Group Type EXPERIMENTAL

Pegloticase

Intervention Type BIOLOGICAL

IV infusion

Methotrexate

Intervention Type DRUG

Oral

Interventions

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Pegloticase

IV infusion

Intervention Type BIOLOGICAL

Methotrexate

Oral

Intervention Type DRUG

Other Intervention Names

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Krystexxa

Eligibility Criteria

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Inclusion Criteria

1. Adult men or women ≥ 18 years of age
2. Uncontrolled gout, defined as meeting the following criteria:

* Hyperuricemia during the Screening Period, defined as sUA ≥ 7 mg/dL, and;
* Failure to maintain normalization of sUA with xanthine oxidase inhibitors at the maximum medically appropriate dose, or with a contraindication to xanthine oxidase inhibitor therapy based on medical record review or participant interview, and;
* Symptoms of gout
3. Willing to discontinue any oral ULT for at least 7 days prior to MTX dosing at Week -4 and continue not receiving any oral ULT when receiving pegloticase/placebo for pegloticase infusions
4. Women of childbearing potential must have negative serum/urine pregnancy tests during screening and Week -4.
5. Men who are not vasectomized must agree to use appropriate contraception, so as to not impregnate a female partner of reproductive potential during the trial.

Exclusion Criteria

1. Severe chronic or recurrent bacterial infections, such as recurrent pneumonia or chronic bronchiectasis
2. Current or chronic treatment with systemic immunosuppressive agents, such as MTX, azathioprine or mycophenolate mofetil; prednisone \> 10 mg/day or equivalent dose of other corticosteroid on a chronic basis (3 months or longer)
3. History of any transplant surgery requiring maintenance immunosuppressive therapy
4. Known history of hepatitis B virus surface antigen positivity or hepatitis B DNA positivity
5. Known history of hepatitis C virus RNA positivity, unless treated and viral load is negative
6. Known history of human immunodeficiency virus (HIV) positivity
7. G6PD deficiency (quantitative test at the Screening Visit centrally or locally)
8. Non-compensated congestive heart failure or hospitalization for congestive heart failure within 3 months of the Screening Visit, uncontrolled arrhythmia, treatment for acute coronary syndrome (myocardial infarction or unstable angina) or uncontrolled blood pressure (\> 160/100 mmHg) prior to Week -4
9. Pregnant, planning to become pregnant, breastfeeding, planning to impregnate female partner or not on an effective form of birth control, as determined by the Investigator
10. Prior treatment with pegloticase, another recombinant uricase (rasburicase) or concomitant therapy with a PEG-conjugated drug
11. Unable to tolerate MTX 15 mg orally during the MTX Run-in Period
12. Chronic liver disease
13. White blood cell count \< 4,000/μL, hematocrit \< 32% or platelet count \< 75,000/μL
14. Currently receiving systemic or radiologic treatment for ongoing cancer
15. History of malignancy within 5 years other than non-melanoma skin cancer or in situ carcinoma of cervix
16. Diagnosis of osteomyelitis
17. Known history of hypoxanthine-guanine phosphoribosyl-transferase deficiency, such as Lesch-Nyhan and Kelley-Seegmiller syndrome
18. A known intolerance to all protocol-standard gout flare prophylaxis regimens (i.e., participant must be able to tolerate at least 1 of the following: colchicine and/or non-steroidal anti-inflammatory drugs and/or low-dose prednisone ≤ 10 mg/day)
19. Current pulmonary fibrosis, bronchiectasis or interstitial pneumonitis. If deemed necessary by the Investigator, a chest X-ray may be performed during Screening.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Amgen

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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MD

Role: STUDY_DIRECTOR

Amgen

Locations

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The University of Alabama at Birmingham (UAB)

Birmingham, Alabama, United States

Site Status

Orthopedic Physicians Alaska - Rheumatology and Infusion

Anchorage, Alaska, United States

Site Status

Arizona Arthritis and Rheumatology Associates - Chandler

Chandler, Arizona, United States

Site Status

Arizona Arthritis and Rheumatology Rese

Flagstaff, Arizona, United States

Site Status

Arizona Arthritis & Rheumatology Research, PLLC

Gilbert, Arizona, United States

Site Status

Arizona Arthritis & Rheumatology Research, PLLC

Mesa, Arizona, United States

Site Status

Arizona Arthritis and Rheumatology Research, PLLC

Mesa, Arizona, United States

Site Status

Arizona Arthritis and Rheumatology Research, PLLC

Phoenix, Arizona, United States

Site Status

Arizona Arthritis and Rheumatology Research

Phoenix, Arizona, United States

Site Status

Arizona Arthritis & Rheumatology Research, PLLC

Sun City, Arizona, United States

Site Status

Arizona Arthritis and Rheumatology

Tucson, Arizona, United States

Site Status

Covina Arthritis Clinic

Covina, California, United States

Site Status

Medvin Clinical Research- Riverside

Hemet, California, United States

Site Status

Velocity Clinical Research - Boise - ERN - PPDS

North Hollywood, California, United States

Site Status

TriWest Research Associates

San Diego, California, United States

Site Status

Precision Comprehensive Clinical Research Solutions

San Leandro, California, United States

Site Status

Saint John's Health Center - Providence St John's Health Ctr

Santa Monica, California, United States

Site Status

C.V. Mehta MD Medical Corporation

Temecula, California, United States

Site Status

Foothill Arthritis

Tujunga, California, United States

Site Status

Medvin Clinical Research

Whittier, California, United States

Site Status

University of Colorado Denver

Aurora, Colorado, United States

Site Status

Lynn Institute of the Rockies

Colorado Springs, Colorado, United States

Site Status

Denver Arthritis Clinic - Rheumatology

Denver, Colorado, United States

Site Status

Arthritis & Rheumatic Disease

Aventura, Florida, United States

Site Status

Prohealth Research Center

Doral, Florida, United States

Site Status

Life Clinical Trials

Margate, Florida, United States

Site Status

Homestead Associates in Research,Inc

Miami, Florida, United States

Site Status

D&H National Research Centers, Inc.

Miami, Florida, United States

Site Status

Well Pharma

Miami, Florida, United States

Site Status

Felicidad Medical Research, LLC.

Miami, Florida, United States

Site Status

New Generation Of Medical Research

Naples, Florida, United States

Site Status

IRIS Research & Development

Plantation, Florida, United States

Site Status

D&H Pompano Research Center

Pompano Beach, Florida, United States

Site Status

D&H Tamarac Research Center

Tamarac, Florida, United States

Site Status

GCP Clinical Research

Tampa, Florida, United States

Site Status

ClinPro Research Solutions, LLC

Tampa, Florida, United States

Site Status

Arthritis Center of North Georgia

Gainesville, Georgia, United States

Site Status

Vista Clinical Research, LLC

Newnan, Georgia, United States

Site Status

Great Lakes Clin. Trials

Chicago, Illinois, United States

Site Status

Conquest Research - Anesthesiology/Pain Medicine

Chicago, Illinois, United States

Site Status

Great Lakes Clinical Trials - Gurnee

Highland Park, Illinois, United States

Site Status

Crowley CORE - Illinois Bone and Joint Institute

Hinsdale, Illinois, United States

Site Status

Lake Cumberland Rheumatology, PLLC

New Albany, Indiana, United States

Site Status

L-MARC Research Center

Louisville, Kentucky, United States

Site Status

Velocity CR - New Orleans

Covington, Louisiana, United States

Site Status

Velocity CR - New Orleans

New Orleans, Louisiana, United States

Site Status

Michigan Medicine

Ann Arbor, Michigan, United States

Site Status

June DO,PC

Lansing, Michigan, United States

Site Status

Clinical Research Institute of Michigan, LLC

Saint Clair Shores, Michigan, United States

Site Status

Inspire Santa Fe Medical Group

Santa Fe, New Mexico, United States

Site Status

Velocity Clinical Research-Vestal

Vestal, New York, United States

Site Status

OnSite Clinical Solutions, LLC

Charlotte, North Carolina, United States

Site Status

Research Carolina Elite

Denver, North Carolina, United States

Site Status

Triad Clinical Trials - Gastroenterology

Greensboro, North Carolina, United States

Site Status

Accellacare of Hickory

Hickory, North Carolina, United States

Site Status

Cape Fear Arthritis Care

Leland, North Carolina, United States

Site Status

Shelby Clinical Research - Family Medicine

Shelby, North Carolina, United States

Site Status

Velocity Clinical Research- Cincinatti

Cincinnati, Ohio, United States

Site Status

Velocity Clinical Research - Cleveland

Cleveland, Ohio, United States

Site Status

Lynn Health Science Institute

Oklahoma City, Oklahoma, United States

Site Status

Altoona Center for Clinical Research

Duncansville, Pennsylvania, United States

Site Status

Velocity Clinical Research, Spartanburg - Pulmonology

Greenville, South Carolina, United States

Site Status

Premier Clinics Pa - Rock Hill, Sc

Rock Hill, South Carolina, United States

Site Status

Low Country Rheumatology

Summerville, South Carolina, United States

Site Status

Amarillo Center for Clinical Research, Ltd.

Amarillo, Texas, United States

Site Status

Clinical Trial Network

Austin, Texas, United States

Site Status

Synergy Groups Medical LLC

Houston, Texas, United States

Site Status

Pioneer Research Solutions, Inc.

Houston, Texas, United States

Site Status

AIM Trials - Internal Medicine

Plano, Texas, United States

Site Status

Clinical Trials of Texas, Inc.

San Antonio, Texas, United States

Site Status

Texas Research Center

Sugar Land, Texas, United States

Site Status

Velocity Clinical Research - Salt Lake City (West Jordan)

West Jordan, Utah, United States

Site Status

Velocity Clinical Research-Portsmouth

Portsmouth, Virginia, United States

Site Status

Arthritis Northwest, PLLC - Research

Spokane, Washington, United States

Site Status

Countries

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United States

Related Links

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http://www.amgentrials.com

AmgenTrials clinical trials website

Other Identifiers

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HZNP-KRY-409

Identifier Type: -

Identifier Source: org_study_id

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