Gout Flares Reduced with Protein-trapping Treatment

PHILADELPHIA – Patients with gout – a painful type of inflammatory arthritis caused by the crystallization of urates in soft tissues – are advised to start treatment that lowers uric acid levels in the blood. Unfortunately, as the long-term medication starts to break down crystals deposited in the joints, many patients experience gout attacks caused by the release of crystals from softened deposits.

Now, these painful gout attacks may be preventable. Using a drug shown to substantially reduce gout flares, new research performed at the Perelman School of Medicine at the University of Pennsylvania and published in Arthritis & Rheumatism, a journal of the American College of Rheumatology (ACR), showed that rilonacept effectively halts the cascade of events leading to these flare-ups, compared with placebo, by acting as a decoy to attract and then trap the pro-inflammatory cytokine interleukin-1 (IL-1).

This is the first study to demonstrate an effective prophylactic treatment to prevent acute gout flares during initiation of urate-lowering therapy.

In a randomized, double-blind, placebo-controlled Phase II trial, there were significantly fewer gout flares (6 flares on rilonacept, 33 flares on placebo) and a significantly lower percentage of patients with flares on rilonacept compared with placebo (15 percent  vs 45 percent).

“This trial provides well-controlled evidence that this IL-1 blocker is effective in preventing acute gout flares in this setting,” said the study's lead author, H. Ralph Schumacher, Jr., MD, professor of Medicine in Rheumatology with the Perelman School of Medicine at the University of Pennsylvania.

The study was sponsored by Regeneron Pharmaceuticals, Inc, the maker of rilonacept. Dr. Schumacher has received consulting fees from Regeneron, Takeda, Savient, Ardea, Pfizer, Xoma, and Novartis.

For more information on the study, see the Arthritis & Rheumatism press release.