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Quarterly Canakinumab Reduces Risk for Gout Attacks

WEDNESDAY, Sept. 19, 2018 -- Quarterly canakinumab administration is associated with significantly reduced risk for gout attacks without any change in serum uric acid levels, according to a study published online Sept. 18 in the Annals of Internal Medicine.

Daniel H. Solomon, M.D., from Brigham and Women's Hospital in Boston, and colleagues evaluated the association between canakinumab, a monoclonal antibody targeting interleukin-1β; serum uric acid levels; and the incidence of gout attacks. Participants (10,059 with a prior myocardial infarction and a high-sensitivity C-reactive protein level ≥19.1 nmol/L) were included in a randomized trial of canakinumab (50 mg, 150 mg, or 300 mg) versus placebo, administered subcutaneously every three months.

The researchers found that for participants receiving placebo, incidence rates of gout attacks for serum uric acid concentrations of ≤404.5 µmol/L were 0.28 per 100 person-years, 1.36 per 100 person-years for concentrations 404.6 to 535.3 µmol/L, and 5.94 per 100 person-years for concentrations ≥535.4 µmol/L. For all baseline concentrations of serum uric acid, canakinumab did not affect serum uric acid levels over time, but significantly reduced rates of gout attacks: hazard ratios, 0.40 for concentrations of ≤404.5 µmol/L; 0.48 for those between 404.6 and 535.3 µmol/L; and 0.45 for concentrations ≥535.4 µmol/L.

"These data have relevance for the development of agents for gout that target the interleukin-1β pathway of innate immunity," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Novartis, which manufactures canakinumab and funded the study.

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Posted: September 2018

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