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Canakinumab administered at variable doses every 3 months was associated with a significant reduction in the risk of gout attacks, without altering serum uric acid levels, according to new data from the CANTOS trial published in Annals of Internal Medicine.
"In examining diseases, we try to paint a picture of the relationship between gout, cardiovascular disease and inflammation." Daniel H. Solomon, MD, MPH, Brigham and Women's Hospital, said in a press release. "It has long been understood that gout and cardiovascular disease travel together. We use the data from the CANTOS trial to understand why.
Although previous research has shown that interleukin-1-beta (IL-1-beta) inhibitors, such as canakinumab (Ilaris, Novartis), reduce cardiovascular events and lung cancer mortality, as well as gout attacks, no tests had the inhibitor of IL-1-beta could completely prevent gout attacks.
According to new data from the CANTOS trial, canakinumab administered every 3 months at varying doses was linked to a significant reduction in the risk of gout attacks.
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To evaluate if canakinumab reduced the risk of gout attacks and if initial concentrations of serum uric acid (SUA) had an impact, Solomon and his colleagues performed a post hoc analysis of the data. CANTOS trials comparing rates of gout attacks in patients (n = 6,717) received three different doses of canakinumab (50 mg, 150 mg and 300 mg) every 3 months until the end of the day. 39; test.
In addition, the researchers used Cox proportional hazard regression models to compare the rate of gout attacks in patients with varying initial concentrations of SUA (404.5 mol / L, 404.6 mol / L, and 535 , 4 mol / L).
According to the results of the study, the risk of first gout attack was reduced by 52% (HR = 0.48, 95% CI, 0.36-0.63) in patients receiving canakinumab compared with placebo. The researchers noted that this effect was observed in all canakinumab assays and did not depend on a history of gout.
Solomon and colleagues found that although canakinumab did not affect SUA levels over time, it significantly reduced gout attack rates at all initial AUS concentrations: 0.4 (95% CI) , 0.22-0.73) or lower; 0.48 (95% CI, 0.31-0.74) for patients with 404.6 mol / L at 535.3 mol / L; and 0.45 (95% CI, 0.28-0.72) for patients with levels of 535.4 mol / L or greater.
"Unlike the data previously reported by CANTOS on major adverse cardiovascular events and lung cancer, reducing the risk of gout attacks did not depend on the dosage of canakinumab," Solomon and colleagues wrote. "Because the benefits were profound and were observed with the lowest dose of canakinumab, our data provide a proof of concept that a low dose of IL-1-beta inhibition could prevent the incidence of gout attacks, especially in failed patients. " by Robert Stott
Disclosure: CANTOS was funded by Novartis.
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