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Efficacy of Canakinumab vs. triamcinolone acetonide according to multiple gouty arthritis-related health outcomes measures.

AbstractAIM:
Canakinumab (CAN), a selective, fully human, anti-IL-1β monoclonal antibody, has demonstrated long-term benefits in gouty arthritis (GA) patients, who have contraindications for, or are unresponsive or intolerant of, non-steroidal anti-inflammatory drugs (NSAIDs) or colchicine (two trials:β-RELIEVED [n = 228]; β-RELIEVED II [n = 226]). The trials collected different responses, including patient-reported outcomes (PRO). A composite response end-point (CRE) was used to interpret each patient's overall response to treatment.
METHODS:
Data from β-RELIEVED trials were pooled for this retrospective analysis. The CRE representing overall change in GA-related health outcomes, from baseline to 12 weeks, included clinical markers; PROs from the Gout Impact Scale (GIS); and the SF-36 bodily pain scale. Response to each variable (i.e. markedly important difference) was determined a priori. Variable values [1 (responder) or 0 (non-responder)] were summed to create a CRE score for each patient.
RESULTS:
For eight of 12 variables measured, the percentage of CAN responders was significantly greater than for TA (p < 0.05). On average, patients receiving CAN met a higher percentage of response criteria (65%) than patients receiving triamcinolone acetonide (TA) (49%), p < 0.001. Mean CRE scores were significantly higher for CAN vs. TA (mean [SD]; 4.7 [2.7] vs. 3.7 [2.4], p < 0.001). Treatment differences remained even after serially removing individual responder variables and domains from the composite end-point, indicating that the differences between CAN and TA were robust.
CONCLUSION:
CAN was superior to TA across multiple health-outcome variables comprising clinical markers and PRO over 12 weeks in patients contraindicated, intolerant or unresponsive to NSAIDs and/or colchicine.
AuthorsJ D Hirsch, A Gnanasakthy, R Lale, K Choi, A J Sarkin
JournalInternational journal of clinical practice (Int J Clin Pract) Vol. 68 Issue 12 Pg. 1503-7 (Dec 2014) ISSN: 1742-1241 [Electronic] India
PMID25298264 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2014 John Wiley & Sons Ltd.
Chemical References
  • Anti-Inflammatory Agents, Non-Steroidal
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Interleukin-1beta
  • canakinumab
  • Triamcinolone Acetonide
Topics
  • Adult
  • Aged
  • Anti-Inflammatory Agents, Non-Steroidal (pharmacology, therapeutic use)
  • Antibodies, Monoclonal (pharmacology, therapeutic use)
  • Antibodies, Monoclonal, Humanized
  • Arthritis, Gouty (drug therapy, mortality)
  • Female
  • Humans
  • Interleukin-1beta (pharmacology, therapeutic use)
  • Male
  • Middle Aged
  • Patient Outcome Assessment
  • Retrospective Studies
  • Triamcinolone Acetonide (pharmacology, therapeutic use)

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