Cardiovascular Safety of Febuxostat and Allopurinol in Patients With Gout and Cardiovascular Comorbidities (CARES)

Investigator:  Christina Bright, MD

Status: Recruiting

Phase: 3

Sponsor: Takeda

Contact: Alisa Huson, 541-706-6592 or

Location: Bend, Oregon (Central Oregon)

Purpose:  The purpose of this study is to see whether subjects with gout who receive febuxostat or allopurinol for up to 9 years have a higher rate of serious heart and blood vessel complications (major cardiovascular events). Examples of major cardiovascular events include heart attacks, strokes, and angina (chest pain due to narrowing of the blood vessels of the heart) that need to be treated urgently with a heart operation. The overall duration of the study is dependent on the number of predefined major cardiovascular events (MACE). The length of study is expected to be approximately 9 years in order to observe the required 624 MACE. The length of study participation for each subject will vary due to the event driven study design.

Inclusion Criteria:

  • The subject is male ≥50 years of age or female ≥55 years of age and at least 2-years post-menopausal.
  • Has a history of major cardiovascular or cerebrovascular disease including at least one of the following:
    • Myocardial infarction
    • Hospitalized unstable angina
    • Cardiac or cerebrovascular revascularization procedure
    • Stroke
    • Hospitalized for transient ischemic attack
    • Peripheral vascular disease
    • History of diabetes mellitus with evidence of micro- or macrovascular disease
  • Has a history or presence of gout defined as having one or more of the American Rheumatism Association criteria for the diagnosis of gout:
    • A tophus proven to contain urate crystals by chemical or polarized light microscopic means, and/or
    • Characteristic urate crystals in the joint fluid, and/or
    • History of at least 6 of the following clinical, laboratory, and x-ray phenomena:
      • More than 1 attack of acute arthritis
      • Maximum inflammation developed within 1 day
      • Monoarticular arthritis
      • Redness observed over joints
      • First metatarsophalangeal joint painful or swollen
      • Unilateral first metatarsophalangeal joint attack
      • Unilateral tarsal joint attack
      • Tophus (proven or suspected)
      • Hyperuricemia
      • Asymmetric swelling within a joint on x-ray
      • Subcortical cysts without erosions on x-ray
      • Joint fluid culture negative for organisms during attack
  • Must have either:
    • a serum urate level greater than or equal to 7.0 mg/dL at the Day -7 Visit OR
    • a serum urate level greater than or equal to 6.0 mg/dL at the Day -7 Visit AND inadequately controlled gout

Exclusion Criteria:

  • Has secondary hyperuricemia
  • Has a history of xanthinuria
  • Has received urate-lowering or excluded medication during the screening period
  • Has a known hypersensitivity to febuxostat or allopurinol or any components of their formulation
  • Has active peptic ulcer disease
  • Has a history of cancer within 5 years prior to the first dose of study medication
  • Had a myocardial infarction or stroke within 60 days prior to the Screening Visit
  • Has alanine aminotransferase and/or aspartate aminotransferase values greater than 2 times the upper limit of normal during the Screening period
  • Has a history of drug abuse or a history of alcohol abuse within 5 years prior to the Screening Visit or the subject consumes more than14 alcoholic beverages per week
  • Has received any investigational medicinal product within the 30 days prior to the Screening Visit and throughout the study
  • Has an estimated creatinine clearance less than 30 mL/min
  • Is required to take excluded medications
  • Has a known history of infection with hepatitis B, hepatitis C, or human immunodeficiency virus

See this trial at

For general inquiries, please contact the BMC Research Department at or 877-692-8338.

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