Patients treated with febuxostat for early gout had lower overall rate of flares

Results from this study demonstrated patients with early gout treated with febuxostat had improvements in MRI synovitis and a decrease in gout flares compared with patients in a placebo group.

Nicola Dalbeth

“Typically, studies of urate-lowering therapy recruit people with longstanding gout,” Nicola Dalbeth, MD, FRACP, study co-author, rheumatologist and professor at the department of medicine at the University of Auckland in New Zealand, told Healio Rheumatology. “This placebo-controlled [randomized controlled trial] RCT examined the effect of urate-lowering therapy in people with earlier disease who had experienced only one or two gout flares. The key finding of this study was that in this patient group, the urate-lowering drug febuxostat reduced joint inflammation detected by MRI scanning and also reduced the frequency of gout flares over the 2-year study period.”

Dalbeth and colleagues performed a double-blind, placebo-controlled study of 314 patients with hyperuricemia and early gout. Patients were randomized to receive either once-daily febuxostat 40 mg (or 80 mg if their serum uric acid [sUA] levels did not improve by day 14) or placebo. The primary endpoint was mean change from baseline to 24 months for the modified Sharp-van der Heijde (mSvdH) erosion score using X-rays of the affected joint. Other endpoints were change from baseline to 24 months in rheumatoid arthritis MRI scoring (RAMRIS) scores for erosion, edema, synovitis in the single affected joint, gout flare incidences and sUA levels.

During 2 years, investigators found no notable changes in joint erosion for patients treated with febuxostat at 40 mg or 80 mg once daily. Investigators noted the treatment groups were not significantly different with regard to the mean change from baseline to 24 months in mSvdH erosion scores of the single affected joint. At 24 months, the RAMIS synovitis score significantly improved in patients treated with febuxostat at 40 mg or 80 mg compared with patients treated with placebo. Compared with the control group, the treatment groups also showed a decrease in the overall incidence of gout flares and improved sUA control. There were no new safety concerns reported in patients in the treatment groups. – by Monica Jaramillo

Disclosures: Dalbeth reported she receives consulting fees, speaker fees or research grants from Takeda, CymaBay, Ardea Biosciences, AstraZeneca and Horizon. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Dalbeth N, et al. Arthritis Rheumatol. 2017;doi:10.1002/art.40233.