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Researchers outline another big disease target for Novartis’ canakinumab as drug slashes rate of gout flares

We’ve already seen Novartis’ outline of positive data underscoring canakinumab’s ability to reduce risks for cardio patients by tamping down on the interleukin-1β pathway. Now researchers have also outlined how it may help people suffering from gout.

Vas Narasimhan

The data are coming from a secondary analysis of the big CANTOS study, which Novartis is using to make its bid for a potential blockbuster cardio OK. Investigators divvied up patients by low, medium and high scores based on their serum urate level, which triggers painful gout flares. And they found the drug slashed the rate of gout flares by more than half in all three compared to placebo, with a hazard ratio starting at 0.40, then 0.48 and 0.45 for the high group.

The drug, though, did reduce high sensitivity C-reactive protein (hsCRP), as has already been noted in the cardio work.

Daniel Solomon

Back in November, Novartis’ $NVS then development chief and now CEO Vas Narasimhan said that the drug proved more clearly impactful for heart attack patients whose hsCRP level — a measure of inflammation using high-sensitivity C-reactive protein — fell below 2mg/L after three months of treatment. By that score, they tracked a 31% reduction in cardiovascular death and a 31% reduction in all-cause mortality.

Canakinumab is currently approved for rare inflammatory conditions, but Novartis has a much, much bigger market in mind.

Novartis success in cardio took a number of analysts by surprise, and the pharma giant has big plans for breaking into a tough market. Ironwood, meanwhile, has been marketing lesinurad for gout after licensing it from AstraZeneca, which gathered mixed data on its impact.

“Our results demonstrate a striking effect of canakinumab on reducing the risk of gout attacks in atherosclerosis patients,” said Daniel Solomon, Professor of Medicine, Harvard Medical School and Brigham and Women’s Hospital. “Moreover, these data illustrate serum urate as a risk marker for both gout and cardiovascular events, though canakinumab has no effect on serum urate levels due to its mechanism of action.”


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