HealthDay News — 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 September 18 in the Annals of Internal Medicine.

Daniel H. Solomon, MD, 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 ≥19.1nmol/L) were included in a randomized trial of canakinumab (50mg, 150mg, or 300mg) vs placebo, administered subcutaneously every 3 months.

The researchers found that for participants receiving placebo, incidence rates of gout attacks for serum uric acid concentrations of ≤404.5µmol/L were 0.28 per 100 person-years, 1.36 per 100 person-years for concentrations 404.6 to 535.3µmol/L, and 5.94 per 100 person-years for concentrations ≥535.4µmol/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 ≤404.5µmol/L; 0.48 for those between 404.6 and 535.3µmol/L; and 0.45 for concentrations ≥535.4µmol/L. 

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“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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