Gout can be incredibly painful where the main treatment option are nonsteroidal anti-inflammatory drugs (NSAID). Unfortunately NSAIDs are not the best alternative for elderly patients as it may induce heart & kidney failure. I was therefore thrilled to see that canakinumab recently was approved by Läkemedelsverket as a treatment alternative.
The basis for this were two randomized clinical trials from Schlesinger et al. with almost 500 patients in total. The patient demographics present the typical gout patient: average age between 50 and 60, mainly men and most had comorbidities such as chronic kidney disease.
The patients were randomized to either canakinumab or triamcinolone acetonide. The effect on pain after three days was 25 mm vs 35 mm in VAS pain in favor of canakinumab. This was at the cost of slightly more prevalent serious adverse events, 17 vs 7, although there was no study-related mortality (1 case in each group).
In summary: a nice addition to the treatment arsenal for gout.
- N. Schlesinger, R. E. Alten, T. Bardin, H. R. Schumacher, M. Bloch, A. Gimona, G. Krammer, V. Murphy, D. Richard, and A. K. So, “Canakinumab for acute gouty arthritis in patients with limited treatment options: results from two randomised, multicentre, active-controlled, double-blind trials and their initial extensions,” Ann Rheum Dis, pp. annrheumdis–2011–200908, May 2012.