Gout flares are related to cardiovascular occasions. Treating gout to focus on serum urate ranges prevents flares, however whether or not such therapy can even stop cardiovascular occasions is unknown.
An summary by Edoardo Cipolletta and colleagues explored whether or not reaching serum urate ranges of lower than 360 μmol/L inside one yr of the primary prescription of urate-lowering remedy has an impact on the five-year danger of main hostile cardiovascular occasions (MACE). The wok was offered on the European congress of Rheumatology (EULAR 2025).
The authors used English and Swedish primary-care information linked to hospitalization and mortality information for over 116,000 sufferers.
Total, 16,201 sufferers had a MACE throughout follow-up. After meta-analysis, sufferers who achieved a serum urate of 360 μmol/L or much less inside one yr had the next weighted five-year MACE-free total survival and decrease danger of MACE in contrast with those that didn’t.
The findings had been comparable in analyses exploring totally different MACE definitions, when follow-up was censored on remedy discontinuation, when sufferers with out obtainable serum urate through the first yr of follow-up had been excluded, and when every part of MACE was thought of individually.
The authors word there was an interplay between age and urate-lowering methods, because the impact measurement in individuals aged over 65 was considerably better than these aged 65 or below. Moreover, a considerably decrease variety of flares had been recorded in individuals who achieved the serum urate goal.
New therapies are in growth for urate reducing. Pozdeutinurad (AR882) is a novel and selective URAT1 inhibitor which has demonstrated important sustained discount in serum urate, in addition to marked discount in each clinically seen subcutaneous tophi, and whole urate crystal deposition.
Robert Keenan offered long-term security and tolerability of pozdeutinurad alone or together with allopurinol in gout sufferers with subcutaneous tophi—information from a Section II open-label trial.
Over 18 months, most treatment-emergent hostile occasions (TEAE) had been delicate or reasonable in severity, with increased numbers within the first six months. Gout flare—as anticipated—was essentially the most frequent AE noticed within the first six months, with a lowering development in subsequent durations.
There have been 4 severe hostile occasions reported in three sufferers, however none had been thought of associated to pozdeutinurad, allopurinol, or remedy for flare prophylaxis. There have been no serum creatinine elevations or clinically important liver perform abnormalities.
Renal stones had been present in two sufferers—one with and one with out a historical past of nephrolithiasis—however they had been thought of delicate to reasonable, didn’t require therapy, and each sufferers accomplished the examine with no or solely transient interruption of remedy.
The authors conclude that these outcomes help pozdeutinurad as a secure choice for the therapy of sufferers with gout, together with these with each clinically seen and subclinical crystal deposition.
Section III information for ruzinurad—one other URAT1 inhibitor—had been offered by Huihua Ding. Throughout a 16-week double-blind interval, 388 sufferers acquired ruzinurad and 385 allopurinol. At Week 16, considerably better proportions within the ruzinurad group achieved the goal serum urate stage of ≤360 μmol/L on the final two month-to-month measurements, in contrast with the allopurinol group—39.7% versus 26.5%.
The proportion reaching the serum urate goal at Week 16 was 52.6% within the ruzinurad group in comparison with 34.5% with allopurinol—a distinction which was maintained till Week 52.
Throughout the 52-week therapy interval, TEAE occurred in 89.7% and 91.7% of sufferers within the ruzinurad and allopurinol teams, respectively, with the most typical being gout flares, elevated alanine aminotransferase, higher respiratory tract an infection, and elevated blood creatinine.
The vast majority of TEAE had been delicate or reasonable, however severe TEAE occurred in 4.9% and three.1% of sufferers within the ruzinurad and allopurinol teams, respectively. The authors conclude that ruzinurad demonstrated superior urate-lowering over allopurinol, and confirmed a well-tolerated security profile in sufferers with hyperuricemia related to major gout.
Extra data:
Cipolletta E, et al. Cardiovascular outcomes of treat-to-target versus fire-and-forget urate-lowering therapy in gout: emulated goal trial research utilizing linked English and Swedish major care, hospitalisation and mortality information. Introduced at EULAR 2025; OP0005. Ann Rheum Dis (2025) DOI: 10.1136/annrheumdis-2025-eular.B1714
Khanna P, et al. Security and Tolerability of Pozdeutinurad (AR882) Remedy following Lengthy-term Dosing in Sufferers with Power Gouty Arthritis and Subcutaneous Tophi. Introduced at EULAR 2025; OP0300. Ann Rheum Dis (2025) DOI: 10.1136/annrheumdis-2025-eular.B1720
Ding H, et al. Ruzinurad for hyperuricemia related to major gout: a multicenter, randomized, double-blind, active-controlled, part 3 examine. Introduced at EULAR 2025; OP0302. Ann Rheum Dis (2025) DOI: 10.1136/annrheumdis-2025-eular.B872
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European Alliance of Associations for Rheumatology, EULAR
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New concepts in gout administration (2025, June 16)
retrieved 16 June 2025
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