Monday, 16 Sep 2019

You are here

Arhalofenate, URAT-1 Inhibitor, Being Developed for Gout

Good news for gout patients includes the recent approval of Zurampic (lesinurad), a URAT-1 inhibitor, and that effective urate-lowering therapy has significant long-term cardiovascular benefits. 

Fortunately, new drug development continues, including arhalofenate, a novel anti-inflammatory uricosuric. This agent's efficacy is based on being a URAT-1 inhibitor (blocks uric readsorbtion at the proximal tubule) and is also an anti-inflammatory drug.

A 12-week, randomized, controlled trial of 239 hyperuricemic gout patients (with recurrent flares) received daily arhalofenate 600 or 800 mg, allopurinol 300 mg, allopurinol 300 mg + 0.6 mg colchicine or placebo. The primary outcome was the flare incidence at 12 weeks.

The arhalofenate 800 mg had 46% fewer flares compared to allopurinol 300 mg (0.66 versus 1.24, p = 0.0056).  Arhalofenate 800 mg was also significantly better than placebo (p = 0.049), but did not achieve significance compared to allopurinol + colchicine (p = 0.091).

Serum urate significantly decreased -12.5% and -16.5% with arhalofenate 600 mg and 800 mg (p = 0.001 and p=0.0001) more than placebo. Adverse events were not different between groups. 

Arhalofenate appears to be an effective urate-lowering therapy and has shown to be more effective at decreasing gout flares compared to allopurinol.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Modifiable Risk Factors for Hyperuricemia

Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia. 

Researchers examine modifiable risk factors for hyperuricemia and how this could be prevented through risk factor modification in the general population.

Opioids Overused in Acute Gout

Opioids were commonly given to patients as a treatment for acute gout attacks, despite the availability of other effective and appropriate therapies, a retrospective study found.

Allopurinol Fails to Curtail Hypertension

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Allopurinol Fails to Curtail Hypertension

A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Updated 2018 EULAR Recommendations for the Diagnosis of Gout

The first EULAR recommendations for the diagnosis of gout were published in 2006. A task force was formed and following a systematic review, they voted unanimously for changes in all items of the 2006 recommendations.