This article is more than 5 years old. Information may no longer be current.
Lesinurad combination therapy with febuxostat seen as effective in tophaceous gout
Click Here to Manage Email Alerts
Lesinurad combination therapy with febuxostat had better ability to lower serum uric acid levels compared with febuxostat monotherapy and showed an acceptable safety profile in patients with tophaceous gout, according to a recently published analysis.
“For patients uncontrolled on an appropriate dose of an [xanthine oxidase inhibitor] XOI for whom a uricosuric is recommended, there is a need for additional treatment options,” Nicola Dalbeth, MD, FRACP, from the University of Auckland, and colleagues wrote.
“Lesinurad 200 mg is a novel selective uric acid re-absorption inhibitor approved for treatment of gout in combination with an XOI for those not at target [serum uric acid] SUA on an XOI alone.”
Researchers assessed 324 patients with an SUA level of at least 8 mg/dL — and at least 6 mg/dL if on a urate-lowering therapy — and at least one measurable target tophus who received 80 mg of daily febuxostat for 3 weeks before administration of add-on 200 mg or 400 mg of daily lesinurad or placebo. The primary endpoint was the percentage of patients who achieved an SUA level of less than 5 mg/dL at 6 months.
Compared with febuxostat monotherapy (46.8%), significantly more patients who took 400 mg of add-on lesinurad achieved their SUA target at 6 months (76.1%); however, there was not a significant difference for the 200-mg group (56.6%) for this measure. At later time points, significantly more patients in the 200-mg group did achieve their SUA target. There was no difference in complete tophus resolution between groups. Both 200-mg (50.1%) and 400-mg (52.9%) lesinurad groups reduced their total target tophi area compared with the group on febuxostat monotherapy (28.3%). The safety profiles were similar for the three arms, except for higher rates of predominantly reversible serum creatinine elevation, especially in the 400-mg group.
“Combination therapy with lesinurad and febuxostat provides a dual mechanism, addressing both uric acid excretion and urate production, and may represent a treatment option for patients with tophaceous gout on febuxostat who warrant additional therapy,” the researchers wrote. – by Will A. Offit
Disclosures: Dalbeth reports grant support form AstraZeneca and has participated on speaker bureaus for Menarini, AstraZeneca, Takeda and advisory boards for AstraZeneca, Fonterra, Takeda, Pfizer, Cymabay and Crealta.
Click Here to Manage Email Alerts