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Gout Treatment Advances: New Therapies and Cardiovascular Benefits Highlighted at EULAR 2025
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Barcelona, Spain – June 16, 2025 – New data presented at the European Alliance of Associations for Rheumatology (EULAR) annual congress in Barcelona showcases significant advancements in gout treatment, emphasizing the importance of achieving target serum urate levels and introducing novel therapeutic options. The research underscores the link between effective gout management and reduced cardiovascular risk, alongside the development of promising new urate-lowering drugs [[source: EULAR]].
Targeting Serum Urate Levels for Cardiovascular Protection
Gout flares have been linked to an increased risk of cardiovascular events. A study by Edoardo Cipolletta and colleagues,analyzing data from over 116,000 patients in England and Sweden,revealed that achieving a serum urate level of ≤360 μmol/L within the frist year of urate-lowering therapy significantly improved 5-year MACE-free survival and lowered the risk of major adverse cardiovascular events (MACE). This highlights the importance of proactive gout management in mitigating cardiovascular risks [[source: EULAR]].
Did You Know? Maintaining a serum urate level below 360 μmol/L can significantly reduce the risk of cardiovascular events in gout patients.
The study’s findings remained consistent across various analyses, including different MACE definitions and censoring follow-up upon therapy discontinuation. Notably, the beneficial effect was more pronounced in patients over 65 years old. These results reinforce the need for targeted urate-lowering strategies in gout management to improve overall patient outcomes.
Emerging Therapies for Urate Lowering
Several new therapies are under development to effectively lower urate levels in gout patients. Pozdeutinurad (AR882), a selective URAT1 inhibitor, has demonstrated sustained reductions in serum urate and significant reductions in tophi. A Phase 2 open-label trial presented by Robert Keenan evaluated the long-term safety and tolerability of pozdeutinurad, alone or combined with allopurinol, in patients with subcutaneous tophi [[source: EULAR]].
The trial results indicated that pozdeutinurad was generally safe and well-tolerated over 18 months, with most treatment-emergent adverse events (TEAE) being mild to moderate. Gout flares were the most frequent adverse event in the first six months, with a decreasing trend thereafter.There were no clinically significant liver function abnormalities or serum creatinine elevations reported.
Pro tip: Newer gout medications focus on selectively inhibiting URAT1, a key protein involved in uric acid reabsorption in the kidneys.
Another promising therapy, ruzinurad, also a URAT1 inhibitor, was evaluated in a Phase 3 study presented by Huihua ding.The study compared ruzinurad to allopurinol over a 16-week double-blind period. Results showed that a significantly greater proportion of patients in the ruzinurad group achieved the target serum urate level of ≤360 μmol/L at the last two monthly measurements compared to the allopurinol group (39.7% vs. 26.5%). This difference was maintained until Week 52 [[source: EULAR]].
During the 52-week treatment period, TEAE occurred in 89.7% and 91.7% of patients in the ruzinurad and allopurinol groups,respectively. The most common adverse events included gout flares, increased alanine aminotransferase, upper respiratory tract infection, and increased blood creatinine. The study concluded that ruzinurad demonstrated superior urate-lowering efficacy compared to allopurinol and exhibited a well-tolerated safety profile in patients with hyperuricemia associated with primary gout.
gout Treatment Comparison
| Therapy | Mechanism of Action | Efficacy (Target Urate ≤360 μmol/L) | Common Adverse Events |
|---|---|---|---|
| Allopurinol | Urate-lowering therapy [[2]] | 26.5% (at week 16) | Gout flares, increased alanine aminotransferase |
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