25.11.2020

Arsenal of gout can be expanded with a new biological drug

Gout is one of the oldest diseases known to mankind. Deposition in tissues of uric acid crystals leads to the formation of gouty tophi and the development of inflammatory responses, manifested acute recurrent arthritis.

The mainstay of treatment of gout are the drugs acting on the pathogenic mechanism of the disease development, that is, on the synthesis and excretion of uric acid. However, not always the treatment is effective. The search for new drugs that could relieve the symptoms and slow the progression of the disease continues.

The most significant breakthroughs in recent years in rheumatology was the establishment of genetically engineered biological drugs that have been successfully used in patients with rheumatoid arthritis, vasculitis, and other autoimmune diseases. The action of most of these medicines are aimed at suppressing various components of the inflammatory process. Therefore, it is logical to assume that such preparations can be effective in the treatment of gout, the main symptom of which is severe inflammatory reaction.

Held in Amsterdam, European Congress of rheumatology presents the results of the secondary analysis of research CANTOS, published in the autumn in the New England journal of Medicine. The purpose of this analysis was to estimate the impact of receiving canakinumab – human monoclonal antibodies to Il-1β – on for gout. It turned out that the drug reduced the relative risk of gout attacks by 50-60%.

It is interesting that canakinumab has not led to lower levels of uric acid. This confirms its special pathogenetic mechanism of action, directed only to the relief of the inflammatory process. Anti-inflammatory properties canakinumab proves a significant drop in C-reactive protein level in the groups receiving the drug.

According to the authors, the results are quite encouraging and may become a prerequisite to a fundamentally new approach to the treatment of gout. However, the results are yet to be repeated in specifically designed prospective studies.

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