{"id":675404,"date":"2025-06-16T18:20:17","date_gmt":"2025-06-16T15:20:17","guid":{"rendered":"https:\/\/en.buradabiliyorum.com\/new-ideas-in-gout-management\/"},"modified":"2025-06-16T18:20:17","modified_gmt":"2025-06-16T15:20:17","slug":"new-ideas-in-gout-management","status":"publish","type":"post","link":"https:\/\/buradabiliyorum.com\/en\/new-ideas-in-gout-management\/","title":{"rendered":"New ideas in gout management"},"content":{"rendered":"
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Gout flares are associated with cardiovascular events. Treating gout to target serum urate levels prevents flares, but whether such treatment can also prevent cardiovascular events is unknown.<\/p>\n

An abstract by Edoardo Cipolletta and colleagues explored whether achieving serum urate levels of less than 360 \u03bcmol\/L within one year of the first prescript<\/a>ion of urate-lowering therapy has an effect on the five-year risk of major adverse cardiovascular events (MACE). The wok was presented at the European congress of Rheumatology (EULAR<\/a> 2025).<\/p>\n

The authors used English and Swedish primary-care data linked to hospitalization and mortality records for over 116,000 patients.<\/p>\n

Overall, 16,201 patients had a MACE during follow-up. After meta-analysis, patients who achieved a serum urate of 360 \u03bcmol\/L or less within one year had a higher weighted five-year MACE-free overall survival and lower risk of MACE compared with those who did not.<\/p>\n

The findings were similar in analyses exploring different MACE definitions, when follow-up was censored on therapy discontinuation, when patients without available serum urate during the first year of follow-up were excluded, and when each component of MACE was considered separately.<\/p>\n

The authors note there was an interaction between age and urate-lowering strategies, since the effect size in people aged over 65 was significantly greater than those aged 65 or under. Additionally, a significantly lower number of flares were recorded in people who achieved the serum urate target.<\/p>\n

New therapies are in development for urate lowering. Pozdeutinurad (AR882) is a novel and selective URAT1 inhibitor which has demonstrated significant sustained reduction in serum urate, as well as marked reduction in both clinically visible subcutaneous tophi, and total urate crystal deposition.<\/p>\n

Robert Keenan presented long-term safety and tolerability of pozdeutinurad alone or in combination with allopurinol in gout patients with subcutaneous tophi\u2014data from a Phase II open-label trial.<\/p>\n

Over 18 months, most treatment-emergent adverse events (TEAE) were mild or moderate in severity, with higher numbers in the first six months. Gout flare\u2014as expected\u2014was the most frequent AE observed in the first six months, with a decreasing trend in subsequent periods.<\/p>\n

There were four serious adverse events reported in three patients, but none were considered related to pozdeutinurad, allopurinol, or therapy for flare prophylaxis. There were no serum creatinine elevations or clinically significant liver function abnormalities.<\/p>\n

Renal stones were found in two patients\u2014one with and one without a history of nephrolithiasis\u2014but they were considered mild to moderate, did not require treatment, and both patients completed the study with no or only brief interruption of therapy.<\/p>\n

The authors conclude that these results support pozdeutinurad as a safe option for the treatment of patients with gout, including those with both clinically visible and subclinical crystal deposition.<\/p>\n

Phase III data for ruzinurad\u2014another URAT1 inhibitor\u2014were presented by Huihua Ding. During a 16-week double-blind period, 388 patients received ruzinurad and 385 allopurinol. At Week 16, significantly greater proportions in the ruzinurad group achieved the target serum urate level of \u2264360 \u03bcmol\/L at the last two monthly measurements, compared with the allopurinol group\u201439.7% versus 26.5%.<\/p>\n

The proportion achieving the serum urate target at Week 16 was 52.6% in the ruzinurad group compared to 34.5% with allopurinol\u2014a difference which was maintained until Week 52.<\/p>\n

During the 52-week treatment period, TEAE occurred in 89.7% and 91.7% of patients in the ruzinurad and allopurinol groups, respectively, with the most common being gout flares, increased alanine aminotransferase, upper respiratory tract infection, and increased blood creatinine.<\/p>\n

The majority of TEAE were mild or moderate, but serious TEAE occurred in 4.9% and 3.1% of patients in the ruzinurad and allopurinol groups, respectively. The authors conclude that ruzinurad demonstrated superior urate-lowering over allopurinol, and showed a well-tolerated safety profile in patients with hyperuricemia associated with primary gout.<\/p>\n

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More information:<\/strong>
\n Cipolletta E, et al. Cardiovascular outcomes of treat-to-target versus fire-and-forget urate-lowering treatment in gout: emulated target trial studies using linked English and Swedish primary care, hospitalisation and mortality data. Presented at EULAR 2025; OP0005. Ann Rheum Dis<\/i> (2025) DOI: 10.1136\/annrheumdis-2025-eular.B1714<\/a>\n<\/p>\n

Khanna P, et al. Safety and Tolerability of Pozdeutinurad (AR882) Treatment following Long-term Dosing in Patients with Chronic Gouty Arthritis and Subcutaneous Tophi. Presented at EULAR 2025; OP0300. Ann Rheum Dis<\/i> (2025) DOI: 10.1136\/annrheumdis-2025-eular.B1720<\/a><\/p>\n

Ding H, et al. Ruzinurad for hyperuricemia associated with primary gout: a multicenter, randomized, double-blind, active-controlled, phase 3 study. Presented at EULAR 2025; OP0302. Ann Rheum Dis<\/i> (2025) DOI: 10.1136\/annrheumdis-2025-eular.B872<\/a><\/p>\n<\/p><\/div>\n

\n\t\t\t\t\t\t\t\t\t\t\t\tProvided by
\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\tEuropean Alliance of Associations for Rheumatology, EULAR<\/p>\n

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\n Citation<\/strong>:
\n New ideas in gout management (2025, June 16)
\n retrieved 16 June 2025
\n from https:\/\/medicalxpress.com\/news<\/a>\/2025-06-ideas-gout.html\n <\/p>\n

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