Dr. So has received consulting fees, speaking fees, and/or honoraria from Novartis, Wyeth, and Roche (less than $10,000 each).
Canakinumab for the treatment of acute flares in difficult-to-treat gouty arthritis: Results of a multicenter, phase II, dose-ranging study†
Article first published online: 8 JUN 2010
Copyright © 2010 by the American College of Rheumatology
Arthritis & Rheumatism
Volume 62, Issue 10, pages 3064–3076, October 2010
How to Cite
So, A., De Meulemeester, M., Pikhlak, A., Yücel, A. E., Richard, D., Murphy, V., Arulmani, U., Sallstig, P. and Schlesinger, N. (2010), Canakinumab for the treatment of acute flares in difficult-to-treat gouty arthritis: Results of a multicenter, phase II, dose-ranging study. Arthritis & Rheumatism, 62: 3064–3076. doi: 10.1002/art.27600
ClinicalTrials.gov identifier: NCT00798369.
- Issue published online: 8 JUN 2010
- Article first published online: 8 JUN 2010
- Accepted manuscript online: 8 JUN 2010 12:00AM EST
- Manuscript Accepted: 3 JUN 2010
- Manuscript Received: 1 FEB 2010
- Novartis Pharma AG, Basel, Switzerland
To assess the efficacy and tolerability of canakinumab, a fully human anti–interleukin-1β monoclonal antibody, for the treatment of acute gouty arthritis.
In this 8-week, single-blind, double-dummy, dose-ranging study, patients with acute gouty arthritis whose disease was refractory to or who had contraindications to nonsteroidal antiinflammatory 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 100-mm visual analog scale.
Seventy-two hours after treatment, 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 72 hours after treatment could not be determined. The reduction from baseline in pain intensity with canakinumab 150 mg was greater than with triamcinolone acetonide 24, 48, and 72 hours after treatment (differences of −11.5 mm [P = 0.04], −18.2 mm [P = 0.002], and −19.2 mm [P < 0.001], respectively), and 4, 5, and 7 days after treatment (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 versus triamcinolone acetonide). The overall incidence of adverse events was similar for canakinumab (41%) and triamcinolone acetonide (42%); most were mild or moderate in severity.
Our findings indicate that canakinumab 150 mg provides rapid and sustained pain relief in patients with acute gouty arthritis, and significantly reduces the risk of recurrent flares compared with triamcinolone acetonide.