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A Study to Compare the Efficacy of SEL-212 to KRYSTEXXA® in Gout Participants Refractory to Conventional Therapy

Phase 2
Completed
Conditions
Chronic Gout
Interventions
Registration Number
NCT03905512
Lead Sponsor
Selecta Biosciences, Inc.
Brief Summary

This is a randomized, parallel-arm, multicenter study to compare the safety and efficacy profiles of SEL-212 and KRYSTEXXA®. Participants will be randomized 1:1 to receive treatment with SEL-212 or KRYSTEXXA® for 6 months. Efficacy assessments, as measured by serum uric acid (SUA) levels, will be conducted at intervals that are appropriate to determine treatment effect differences. Safety will be monitored throughout the study.

Detailed Description

This is a randomized, parallel-arm, multicenter study to compare the safety and efficacy profiles of SEL-212 and KRYSTEXXA®. Participants will be randomized 1:1 to receive treatment with SEL-212 \[a combination of pegadricase (SEL-037) and ImmTOR (SEL-110)\] or KRYSTEXXA® for 6 months.

Study participants in the SEL-212 arm will receive study drug every 28 days for a total of up to 6 infusions of SEL-212. Study participants in the KRYSTEXXA® arm will receive study drug according to the manufacturer's prescribing information, i.e., every 14 days for a total of up to 12 infusions of KRYSTEXXA®.

Efficacy assessments, as measured by SUA levels, will be conducted at intervals that are appropriate to determine treatment effect differences. Safety will be monitored throughout the study.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
170
Inclusion Criteria
  1. History of symptomatic gout defined as:

    1. ≥ 3 gout flares within 18 months of Screening or
    2. Presence of ≥ 1 tophus or
    3. Current diagnosis of gouty arthritis
  2. At the Screening Visit: male age 21 - 80 years, inclusive, or female of non-childbearing potential age 21-80 years, inclusive, where non-childbearing potential is defined as:

    1. > 6 weeks after hysterectomy with or without surgical bilateral salpingooperhectony or
    2. Post-menopausal (> 24 months of natural amenorrhea)
  3. Has at the Screening Visit SUA ≥ 7 mg/dL, with chronic refractory gout defined as having failed to normalize SUA and whose signs and symptoms are inadequately controlled with xanthine oxidase inhibitors at the medically appropriate dose or for whom these drugs are contraindicated;

  4. Willing to provide written informed consent prior to the conduct of any study specific procedures;

  5. Understands and is willing and able to comply with study requirements, including the schedule of follow-up visits

Key

Exclusion Criteria
  1. Prior exposure to any experimental or marketed uricase (e.g., pegloticase [Krystexxa®], pegadricase [SEL-037], rasburicase [Elitek, Fasturtec]);
  2. History of anaphylaxis or severe allergic reactions to medications;
  3. History of any allergy to pegylated products
  4. Drugs known to interact with Rapamune cannot be used during the trial;
  5. Uncontrolled diabetes;
  6. Glucose-6-phosphate dehydrogenase (G6PD) deficiency;
  7. Uncontrolled hypertension;
  8. Participants whose arrhythmia is unstable on current treatment;
  9. History of coronary artery disease, including myocardial infarction or unstable angina, within the last 6 months;
  10. Congestive heart failure;
  11. History of hematological disorders within 1 year or autoimmune disorders, is immunosuppressed or immunocompromised;
  12. Has received an inactivated vaccine in the previous 3 months or has received a live virus vaccine in the previous 6 months;
  13. Is planning to receive any vaccination or live virus vaccination during the study;

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
SEL-212SEL-212Intravenous (IV) infusion of SEL-212 every 28 days for up to 6 infusions
KRYSTEXXAKRYSTEXXA®IV infusion of KRYSTEXXA® according to the manufacturer's prescribing information every 14 days for up to 12 infusions
Primary Outcome Measures
NameTimeMethod
Number of Participants With Serum Uric Acid (SUA) Reduction of < 6 mg/dL for at Least 80% of the TimeUp to Month 6

The average of the data collected during Month 3 and Month 6 was reported.

Secondary Outcome Measures
NameTimeMethod
Number of Participants With SUA Reduction of < 6 mg/dL for At Least 80% of the Time During Month 6Month 6
Number of Participants With SUA Reduction of < 6 mg/dL for 100% of the Time During Month 6Month 6
Quality of Life (QoL) as Assessed by Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) ScaleBaseline to End of Month 3, Baseline to End of Month 6

Eight categories were assessed by the HAQ-DI: 1) dressing and grooming, 2) arising, 3) eating, 4) walking, 5) hygiene, 6) reaching, 7) gripping, and 8) common daily activities. There were 2 or 3 questions for each category.

Scoring within each category was on a 4-point Likert scale from 0 (without any difficulty) to 3 (unable to do). The score given to each section was the worst (highest) score within the section. The HAQ-DI total score was calculated if 6 or more sections were available. The average of the 8 category scores was reported as the HAQ-DI total score on a scale of 0 to 3. Reduction from baseline, and lower scores indicated better QoL.

QoL as Assessed by Change From Baseline in Provider Global Assessment of Disease Activity (PrGA) ScaleBaseline to End of Month 3, Baseline to End of Month 6

The PrGA was administered to assess the severity of the participant's disease on a scale from 0 (participant feels "very well") to 100 (participant feels "very poor"). Reduction from baseline, and lower scores indicated less severe disease.

QoL as Assessed by Change From Baseline in Short Form Health Survey 36 (SF-36) ScaleBaseline to End of Month 3, Baseline to End of Month 6

The SF-36 is a 36-item questionnaire to assesses a participant's health status using 8 health concepts: limitations in physical activities because of health problems; limitations in social activities because of physical or emotional problems; limitations in usual role activities because of physical health problems; bodily pain; general mental health (psychological distress and well-being); limitations in usual role activities because of emotional problems; vitality (energy and fatigue); and general health perceptions.

The mental component reports the average of all the emotionally relevant items and the physical component reports the average of all the physical relevant items. Each component is directly transformed into a 0 to 100 scale on the assumption that each question carries equal weight. A score of 0 is equal to maximum disability, and a score of 100 indicates no disability. Median change can range from -100 to 100. A positive median change indicated an improved outcome.

Number of Participants With Gout Flares Per 3-Month PeriodMonth 1 to Month 3, Month 4 to Month 6
Number of Gout Flares Per 3-Month PeriodMonth 1 to Month 3, Month 4 to Month 6
Change From Baseline in Number of Tender JointsBaseline to End of Month 6
Change From Baseline in Number of Swollen JointsBaseline to End of Month 6

Trial Locations

Locations (41)

Panax Clinical Research

🇺🇸

Miami Lakes, Florida, United States

Great Lakes Clinical Trials

🇺🇸

Chicago, Illinois, United States

DJL Clinical Research

🇺🇸

Charlotte, North Carolina, United States

Klein & Associates, M.D., P.A.

🇺🇸

Hagerstown, Maryland, United States

Better Health Clinical Research, Inc.

🇺🇸

Newnan, Georgia, United States

Arizona Arthritis & Rheumatology Research, PLLC

🇺🇸

Sun City, Arizona, United States

Arthritis Center of North Georgia

🇺🇸

Gainesville, Georgia, United States

The Center for Rheumatology and Bone Research

🇺🇸

Wheaton, Maryland, United States

Valerius Medical Group and Research Center of Greater Long Beach, Inc.

🇺🇸

Los Alamitos, California, United States

Cape Fear Arthritis Care PLLC

🇺🇸

Leland, North Carolina, United States

Southwest Rheumatology Research, LLC

🇺🇸

Mesquite, Texas, United States

Clinical Research Center of Reading, LLC

🇺🇸

Wyomissing, Pennsylvania, United States

Metroplex Clinical Research Center

🇺🇸

Dallas, Texas, United States

NYU Langone Ambulatory Care Brooklyn Heights

🇺🇸

Brooklyn, New York, United States

MD Strategies Research Centers

🇺🇸

San Diego, California, United States

QPS-Medical Research Assoc LLC

🇺🇸

Miami, Florida, United States

Well Pharma Medical Research Corp.

🇺🇸

Miami, Florida, United States

New Horizons Clinical Research

🇺🇸

Cincinnati, Ohio, United States

Pioneer Research Solutions, Inc.

🇺🇸

Houston, Texas, United States

Duke University Medical Center

🇺🇸

Durham, North Carolina, United States

Arthritis & Rheumatology Center of Oklamhoma, PLLC

🇺🇸

Oklahoma City, Oklahoma, United States

Pinnacle Research Group, LLC

🇺🇸

Anniston, Alabama, United States

Clinical Research of West Florida

🇺🇸

Clearwater, Florida, United States

Arthritis Care and Research Center

🇺🇸

Poway, California, United States

Baptist Health Center for Clinical Research

🇺🇸

Little Rock, Arkansas, United States

Medvin Clinical Research

🇺🇸

Covina, California, United States

Institute of Arthritis Research

🇺🇸

Idaho Falls, Idaho, United States

Clinical Pharmacology Study Group

🇺🇸

Worcester, Massachusetts, United States

Elite Clinical Research, LLC

🇺🇸

Jackson, Mississippi, United States

Tekton Research

🇺🇸

Austin, Texas, United States

Amarillo Center for Clinical Research

🇺🇸

Amarillo, Texas, United States

West Tennessee Research Institute, LLC

🇺🇸

Jackson, Tennessee, United States

TEST

🇺🇸

Blue Springs, Missouri, United States

Austin Regional Clinic

🇺🇸

Austin, Texas, United States

Altoona Center for Clinical Research

🇺🇸

Duncansville, Pennsylvania, United States

Accelerated Enrollment Solutions (AES)

🇺🇸

Orlando, Florida, United States

Rheumatology Associates of Central Florida, PA

🇺🇸

Orlando, Florida, United States

Clinical Research of West Florida, Inc.

🇺🇸

Tampa, Florida, United States

L-MARC Research Center

🇺🇸

Louisville, Kentucky, United States

University Hospital

🇺🇸

Ann Arbor, Michigan, United States

Advent Health Group Multispecialty at Habana and Bruce B. Downs

🇺🇸

Tampa, Florida, United States

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