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Canakinumab for the treatment of acute flares in difficult-to-treat gouty arthritis.

Author(s): So A, De Meulemeester M, Pikhlak A, Yucel AE, Richard D, Murphy V, Arulmani U, Sallstig P, Schlesinger N

Affiliation(s): Department of Rheumatology, University Hospital of Lausanne, 1011 Switzerland.

Publication date & source: 2010-06-08, Arthritis Rheum., [Epub ahead of print]

OBJECTIVE.: To assess the efficacy and tolerability of canakinumab, a fully human anti-interleukin-1beta monoclonal antibody, for the treatment of acute gouty arthritis. METHODS.: In this 8-week, single-blind, double-dummy, dose-ranging study, patients with acute gouty arthritis who were refractory to or had contraindications to non-steroidal anti-inflammatory drugs and/or colchicine were randomized to receive a single subcutaneous dose of canakinumab (10, 25, 50, 90, or 150 mg) (n=143) or an intramuscular dose of triamcinolone acetonide 40 mg (n=57). Patients assessed pain using a 0-100 mm visual analog scale. RESULTS.: At 72 hours post-dose, a statistically significant dose response was observed for canakinumab. All canakinumab doses were associated with numerically less pain than triamcinolone acetonide; thus, a dose with equivalent efficacy to triamcinolone acetonide at 72 hours post-dose could not be determined. The reduction from baseline in pain intensity with canakinumab 150 mg was greater than with triamcinolone acetonide at 24, 48, and 72 hours post-dose (differences of -11.5 mm [P=0.04], -18.2 mm [P=0.002], and -19.2 [P<0.001], respectively), and at 4, 5, and 7 days post-dose (all P<0.05). Canakinumab significantly reduced the risk of recurrent flares versus triamcinolone acetonide (P</=0.01 for all doses); relative risk reduction, 94% for canakinumab 150 mg vs triamcinolone acetonide. The overall incidence of adverse events was similar for canakinumab (41%) and triamcinolone acetonide (42%); most were mild or moderate in severity. CONCLUSION.: Canakinumab 150 mg provided rapid and sustained pain relief in patients with acute gouty arthritis, and significantly reduced the risk of recurrent flares compared with triamcinolone acetonide.

Page last updated: 2010-10-05

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