Gout drug offers hope for thousands of patients battling the painful arthritis

An anti-inflammatory drug may offer hope for thousands of patients battling gout, a study suggests.

Scientists tested canakinumab on thousands of heart attack patients and found it halved their risk of suffering a gout attack.

Gout, a form of arthritis, is heavily linked to heart disease – a major cause of heart attacks – and the pair often come hand-in-hand.

The Brigham and Women’s Hospital study bolsters evidence to link the two and offers a potential way of treating both with the same drug.

Canakinumab, already approved by drug regulators to treat gout in the UK, targets interleukin-1β – a chemical produced by cells which helps control how a body responds to cells of the immune system.

But it has not yet been approved by the Food and Drug Administration (FDA) for use in the US.

The drug canakinumab, brand name Ilaris in the US, halved the number of gout episodes patients had after suffering a heart attack, when compared to a placebo

Gout is the result of a build-up of uric acid in the blood and affects four per cent of adults in the UK and more than eight million in the US.

The form of arthritis, caused by a build-up of uric acid, a waste product of the body, famously afflicted Henry VIII and was rife in the Victorian era.

All of the 10,000 patients analysed in the study, published in the Annals of Internal Medicine, had once suffered a heart attack.

They all also had much higher levels of high-sensitivity C-reactive protein (hsCRP), a clear indicator of inflammation within the body.

WHAT IS GOUT?

Gout is the result of a build-up of uric acid in the blood and affects 200,000 people, most of them men, in the UK and around eight million people in the US.

How is it diagnosed?

Detecting gout before the symptoms become apparent is difficult.

Men whose father and grandfathers suffer from gout are more prone to getting it. Once symptoms do appear, a test can find out how much uric acid is in the blood.

What are the symptoms?

Gout tends to mainly affect the knees, ankles and big toe joints. It often appears as an acute attack, usually coming on overnight. Within 24 hours there is severe pain and swelling in the affected joint, and the skin may be red and shiny.

When patients first develop gout there may be intervals of months, or even years, between attacks. As time goes by, these tend to become more frequent and more severe, and eventually other joints may be involved.

Once the gout reaches this stage, a state of chronic or continuous joint disease may develop, with progressive joint damage. The sufferer may even become permanently crippled.

Researchers led by Dr Daniel Solomon collected information on the number of gout attacks the trial participants endured.

And tests were also taken to measure how much urate – which forms the painful crystals in the joints of gout patients – was in their blood.

Patients either took a placebo for months, or were given canakinumab – manufactured by Novartis – for the same amount of time.

Three per cent of participants on the placebo suffered a gout attack over the trial period, compared to just 1.5 per cent of those taking canakinumab..

But blood levels of urate remained unchanged over the course of the study, suggesting the drug slashed the risk of gout in a different way.

Studies have already shown that canakinumab can help shorten the length of gout attacks, prompting Nice – which regulates drugs for the NHS – to recommend the drug for gout patients in the UK.

However, the Food and Drug Administration has yet to approve the drug, sold under the brand name of Ilaris, for gout in the US.

Gout sufferers are 15 per cent more likely to die if they have a heart attack or stroke than patients without the joint condition, a study concluded last month.

Cardiologists at North Carolina’s Duke University analysed data from more than 17,000 heart disease patients to make the conclusion.

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