Canakinumab reduces the risk of acute gouty arthritis flares during initiation of allopurinol treatment: results of a double-blind, randomised study

@article{Schlesinger2011CanakinumabRT,
  title={Canakinumab reduces the risk of acute gouty arthritis flares during initiation of allopurinol treatment: results of a double-blind, randomised study},
  author={Naomi Schlesinger and Eduardo Mysler and Hsiao-Yi Lin and Marc De Meulemeester and Jozef Rovensk{\'y} and Udayasankar Arulmani and Alison Balfour and Gerhard Dr. Krammer and Peter Sallstig and Alexander So},
  journal={Annals of the Rheumatic Diseases},
  year={2011},
  volume={70},
  pages={1264 - 1271}
}
Objective This study assessed the efficacy and safety of canakinumab, a fully human anti-interleukin 1β monoclonal antibody, for prophylaxis against acute gouty arthritis flares in patients initiating urate-lowering treatment. Methods In this double-blind, double-dummy, dose-ranging study, 432 patients with gouty arthritis initiating allopurinol treatment were randomised 1:1:1:1:1:1:2 to receive: a single dose of canakinumab, 25, 50, 100, 200, or 300 mg subcutaneously; 4×4-weekly doses of… 
Canakinumab for acute gouty arthritis in patients with limited treatment options: results from two randomised, multicentre, active-controlled, double-blind trials and their initial extensions
TLDR
Canakinumab provided significant pain and inflammation relief and reduced the risk of new flares in these patients with acute gouty arthritis.
Rilonacept (interleukin-1 trap) in the prevention of acute gout flares during initiation of urate-lowering therapy: results of a phase II randomized, double-blind, placebo-controlled trial.
TLDR
It is indicated that rilonacept significantly reduces the frequency of gout flares during the initial period of treatment with urate-lowering therapy, with a favorable safety profile.
Canakinumab: A Guide to Its Use in Acute Gouty Arthritis Flares
TLDR
On-demand treatment with subcutaneous canakinumab 150 mg significantly relieved the pain and inflammation of a new gout flare, and reduced the risk of new flares in patients with acute gouty arthritis flares in whom standard treatment with non-steroidal anti-inflammatories and/or colchicine was inappropriate.
Rilonacept for Gout Flare Prevention in Patients Receiving Uric Acid-lowering Therapy: Results of RESURGE, a Phase III, International Safety Study
Objective. To evaluate the safety and efficacy of once-weekly subcutaneous rilonacept 160 mg for prevention of gout flares in patients initiating or continuing urate-lowering therapy (ULT). Methods.
Prophylaxis for acute gout flares after initiation of urate-lowering therapy.
TLDR
Evidence relating to prophylaxis for gout flares after the initiation of urate-lowering therapy (ULT) is summarized using MEDLINE via PubMed for articles published in English from 1963 to 2013 using MEsH terms, finding low-dose colchicine and low- dose NSAIDs are the recommended first-line therapies.
Efficacy of anakinra in gouty arthritis: a retrospective study of 40 cases
TLDR
Anakinra may be efficient in gouty arthritis, is relatively well tolerated with short-term use, and could be a relevant option in managing g outy arthritis when conventional therapies are ineffective or contraindicated.
Advances in pharmacotherapy for the treatment of gout
TLDR
The review describes the current treatments for urate-lowering therapy including allopurinol, febuxostat, probenecid, benzbromarone and pegloticase and anti-inflammatory treatment of acute flares.
Effect of canakinumab on clinical and biochemical parameters in acute gouty arthritis: a meta-analysis
TLDR
This meta-analysis shows the beneficial effect of canakinumab over triamcinolone by reducing VAS score, serum hsCRP, serum amyloid A, and improvement in global assessments in acute gouty arthritis.
Canakinumab in gout
  • N. Schlesinger
  • Medicine, Biology
    Expert opinion on biological therapy
  • 2012
TLDR
Canakinumab has been found to be superior to triamcinolone acetonide in acute gout and to colchicine in gout attack prophylaxis in reducing pain and risk of new gout attacks.
...
...

References

SHOWING 1-10 OF 40 REFERENCES
Canakinumab for the treatment of acute flares in difficult-to-treat gouty arthritis: Results of a multicenter, phase II, dose-ranging study.
TLDR
It is indicated that canakinumab 150 mg provides rapid and sustained pain relief in patients with acute gouty arthritis, and significantly reduces the risk of recurrent flares compared with triamcinolone acetonide.
Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis.
TLDR
Colchicine prophylaxis during initiation of allopurinol for chronic gouty arthritis reduces the frequency and severity of acute flares, and reduces the likelihood of recurrent flares.
Use of canakinumab in the cryopyrin-associated periodic syndrome.
TLDR
Treatment with subcutaneous canakinumab once every 8 weeks was associated with a rapid remission of symptoms in most patients with CAPS and evaluated therapeutic responses using disease-activity scores and analysis of levels of C-reactive protein (CRP) and serum amyloid A protein (SAA).
Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase: a twenty-eight-day, multicenter, phase II, randomized, double-blind, placebo-controlled, dose-response clinical trial examining safety and efficacy in patients with gout.
TLDR
Treatment with febuxostat resulted in a significant reduction of sUA levels at all dosages and was safe and well tolerated.
Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial.
TLDR
At all doses studied, febuxostat more effectively lowered and maintained serum urate levels <6.0 mg/dl than did allopurinol (300 or 100 mg) or placebo in subjects with hyperuricemia and gout, including those with mild to moderately impaired renal function.
The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial
TLDR
In subjects with mild/moderate renal impairment, both febuxostat doses were more efficacious than allopurinol and equally safe and at the doses tested, safety of febUXostat and allopURinol was comparable.
Gout – what are the treatment options?
TLDR
Treatment for gout has advanced little in the last 40 years, until recently, but the recent development of new therapeutic options promises to provide much needed alternatives for the many patients with gout who are intolerant of or refractory to available therapies.
Febuxostat compared with allopurinol in patients with hyperuricemia and gout.
TLDR
Although the incidence of gout flares diminished with continued treatment, the overall incidence during weeks 9 through 52 was similar in all groups andFebuxostat, at a daily dose of 80 mg or 120 mg, was more effective than allopurinol at the commonly used fixed daily doses of 300 mg in lowering serum urate.
A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy.
TLDR
The data indicate that reduction of serum urate concentrations to 6 mg/dl or lower will eventually result in a reduced frequency or prevention of future gouty attacks.
Developments in the scientific and clinical understanding of gout
  • A. So
  • Biology, Medicine
    Arthritis research & therapy
  • 2008
TLDR
Advances in the understanding of hyperuricemia and gout provide new therapeutic targets for the future and new insights into the transporters that handle uric acid in the kidney are provided.
...
...