Febuxostat Versus Allopurinol Control Trial in Subjects With Gout (FACT)

• Percentage of Subjects With Serum Urate <6.0 mg/dL at Week 28 Visit [ Time Frame: Week 28 ] [ Designated as safety issue: No ]
  Serum urate values were obtained at the Week 28 visit. The percentage of subjects whose serum urate was <6.0 mg/dL at the Week 28 visit was summarized.
• Percentage of Subjects With Serum Urate <6.0 mg/dL at Week 52 Visit [ Time Frame: Week 52 ] [ Designated as safety issue: No ]
  Serum urate values were obtained at the Week 52 visit. The percentage of subjects whose serum urate was <6.0 mg/dL at the Week 52 visit was summarized.
• Percentage of Subjects With Serum Urate <6.0 mg/dL at Final Visit [ Time Frame: Final Visit (up to 52 weeks) ] [ Designated as safety issue: No ]
  The percentage of subjects whose serum urate was <6.0 mg/dL at the final visit was summarized. The final visit was the last visit at which a serum urate value was collected. The timing of the final visit may have differed for each subject.
• Percent Change From Baseline in Serum Urate Levels at Week 28. [ Time Frame: Baseline and Week 28 ] [ Designated as safety issue: No ]
  Serum urate values were obtained at the Week 28 visit. The percent change in serum urate was calculated as [(week 28 - baseline levels/baseline)]*100 and summarized.
• Percent Change From Baseline in Serum Urate Levels at Week 52. [ Time Frame: Baseline and Week 52 ] [ Designated as safety issue: No ]
  Serum urate values were obtained at the Week 52 visit. The percent change in serum urate was calculated as [(week 52 - baseline levels/baseline)]*100 and summarized.
• Percent Change From Baseline in Serum Urate Levels at Final Visit [ Time Frame: Baseline and Final Visit (up to 52 weeks) ] [ Designated as safety issue: No ]
  The percent change in serum urate from baseline to the Final visit was calculated as [(Final Visit - baseline levels/baseline)]*100 and summarized. The Final visit was the last visit with a serum urate value. The timing of the final visit may have differed for each subject.
• Percent Change From Baseline in Tophus Size at Week 28, as Determined by Physical Measurement, in Subjects With a Palpable Primary Tophus at Screening. [ Time Frame: Baseline and Week 28 ] [ Designated as safety issue: No ]
  The percent change from baseline in primary tophus size as determined by physical measurement was calculated as [(Week 28 - baseline sizes)/baseline]*100 for the subset of subjects with a primary palpable tophus at the Screening Visit. If the primary tophus was no longer palpable at the Week 28 visit, the size was assumed to be zero.
• Percent Change From Baseline in Tophus Size at Week 52, as Determined by Physical Measurement, in Subjects With a Palpable Primary Tophus at Screening. [ Time Frame: Baseline and Week 52 ] [ Designated as safety issue: No ]
  The percent change from baseline in primary tophus size as determined by physical measurement was calculated as [(Week 52 - baseline sizes)/baseline]*100 for the subset of subjects with a primary palpable tophus at the Screening Visit. If the primary tophus was no longer palpable at the Week 52 visit, the size was assumed to be zero.
• Percent Change From Baseline in Tophus Size at Final Visit, as Determined by Physical Measurement, in Subjects With a Palpable Primary Tophus at Screening. [ Time Frame: Baseline and Final Visit (up to 52 weeks) ] [ Designated as safety issue: No ]
  Percent change in primary tophus size was calculated as [(Final Visit - baseline sizes)/baseline]*100 for the subset of subjects with a primary palpable tophus at Screening. If tophus was not palpable at Final visit, the size was assumed to be 0. The timing of the final visit may have differed for each subject.
• Change From Baseline in Total Number of Tophi at Week 28 in Subjects With Palpable Tophi at Screening. [ Time Frame: Baseline and Week 28 ] [ Designated as safety issue: No ]
  The change from baseline at Week 28 in the total number of tophi per subject was calculated for the subset of subjects with palpable tophi at the Screening Visit. If the tophi were no longer palpable at the Week 28 visit, the total count was assumed to be zero.
• Change From Baseline in Total Number of Tophi at Week 52 in Subjects With Palpable Tophi at Screening. [ Time Frame: Baseline and Week 52 ] [ Designated as safety issue: No ]
  The change from baseline at Week 52 in the total number of tophi per subject was calculated for the subset of subjects with palpable tophi at the Screening Visit. If the tophi were no longer palpable at the Week 52 visit, the total count was assumed to be zero.
• Change From Baseline in Total Number of Tophi at Final Visit in Subjects With Palpable Tophi at Screening. [ Time Frame: Baseline and Final Visit (up to 52 weeks) ] [ Designated as safety issue: No ]
  Change in number of tophi/subject calculated for the subset of subjects with palpable tophi at Screening. If the tophi were not palpable at the Final Visit, total count was assumed to be 0. The timing of the final visit may have differed for each subject.
• Percentage of Subjects Requiring Treatment for Gout Flares Between Weeks 8 and 52. [ Time Frame: Weeks 8 through 52 ] [ Designated as safety issue: No ]
  The percentage of subjects requiring treatment for a gout flare between Weeks 8 and 52 of the double-blind treatment period was summarized. A subject who reported more than 1 gout flare during this period was counted only once.

• Reduction in gout flare incidence
• Reduction in tophus size

The purpose of this study is to evaluate the safety and efficacy of febuxostat, once daily (QD), versus allopurinol in subjects with gout.

This was a randomized, controlled, double-blind study of 52 weeks duration. Subjects receiving prior urate-lowering therapy underwent a 2-week washout period prior to randomization. Subjects were then randomized to one of three treatment groups: febuxostat 80 milligram (mg), febuxostat 120 mg, or allopurinol 300 mg. Naproxen (250 mg twice daily) or colchicine (0.6 mg once daily) was provided for prophylaxis of acute gout flares during the washout period and the first 8 weeks of double-blind treatment.

• Drug: Febuxostat
  Febuxostat 80 mg, orally, once daily for up to 52 weeks.
  Other Names:

  • TMX-67
  • Tei-6720
  • Uloric
• Drug: Febuxostat
  Febuxostat 120 mg, orally, once daily for up to 52 weeks.
  Other Names:

  • TMX-67
  • Tei-6720
  • Uloric
• Drug: Allopurinol
  Allopurinol 300 mg, capsules, orally, once daily for up to 52 weeks.

• Experimental: Febuxostat 80 mg QD
  Intervention: Drug: Febuxostat
• Experimental: Febuxostat 120 mg QD
  Intervention: Drug: Febuxostat
• Active Comparator: Allopurinol 300 mg QD
  Intervention: Drug: Allopurinol

• Becker MA, Schumacher HR Jr, Wortmann RL, MacDonald PA, Eustace D, Palo WA, Streit J, Joseph-Ridge N. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Engl J Med. 2005 Dec 8;353(23):2450-61.
• Becker MA, MacDonald PA, Hunt BJ, Lademacher C, Joseph-Ridge N. Determinants of the clinical outcomes of gout during the first year of urate-lowering therapy. Nucleosides Nucleotides Nucleic Acids. 2008 Jun;27(6):585-91.
• Wortmann RL, Macdonald PA, Hunt B, Jackson RL. Effect of prophylaxis on gout flares after the initiation of urate-lowering therapy: analysis of data from three phase III trials. Clin Ther. 2010 Dec;32(14):2386-97.
• Chohan S, Becker MA, Macdonald PA, Chefo S, Jackson RL. Women with gout: Efficacy and safety of urate-lowering with febuxostat and allopurinol. Arthritis Care Res (Hoboken). 2012 Feb;64(2):256-61.

Inclusion Criteria:

• Meeting the preliminary criteria of the American Rheumatism Association for the classification of the acute arthritis of primary gout.
• Serum uric acid ≥ 8.0 milligrams per deciliter (mg/dL) at Baseline

Exclusion Criteria:

• Serum creatinine >1.5 mg/dL
• Calculated creatinine clearance of <50 milliliters per minutes (mL/min)
• Pregnancy or lactation;
• Concurrent therapy with urate lowering agents, azathioprine, 6-mercaptopurine, thiazide diuretics, or medications containing aspirin (>325 mg) or other salicylates;
• Body Mass Index (BMI) >50 kilogram per meter²(kg/m²);
• A history of xanthinuria, active liver disease, or hepatic dysfunction;
• A history of alcohol abuse or intake of 14 or more alcohol-containing drinks/week.