Previous studies have shown that interleukin 1β (IL-1β) inhibitors can shorten gout flares. But prevent the attacks in the first place?
Explore this issueDecember 2018
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Canakinumab targets IL-1β and was recently investigated in the Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS). The randomized, double-blind, placebo-controlled trial was not designed to study gout, but rather to examine canakinumab’s effect on a cardiovascular endpoint. Patients in the trial were randomized to receive placebo or one of three different canakinumab dosages once every three months. The study demonstrated that canakinumab reduces major adverse cardiovascular events.1
An exploratory analysis of the CANTOS trial data reveals that patients who received quarterly canakinumab experienced significantly reduced risk for gout flares even though they did not experience changes in serum uric acid levels. Daniel H. Solomon, MD, MPH, professor of medicine at Harvard Medical School, Boston, and colleagues suggest these data may be relevant as researchers develop gout therapies targeting the IL-1β pathway of innate immunity. The results of their analysis of gout data from the CANTOS trial were published online in the Annals of Internal Medicine.2
The patients in the CANTOS trial had a median baseline serum uric acid (SUA) concentration of 362.9 µmol/L (interquartile range: 309.3–428.3 µmol/L). The investigators followed patients for a median of 3.7 years and tracked the incidence rate of gout flares in patients grouped by their SUA concentration. They note in the study that the concentrations of SUA can change over time and the solubility of uric acid in blood is extremely variable from person to person.