Arhalofenate, URAT-1 Inhibitor, Being Developed for Gout Save

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.