Investigational drugs for hyperuricemia

Abstract

Introduction: The unmet need and the growing prevalence of hyperuricemia and its complications worldwide have pushed investigators to identify new agents to manage hyperuricemia.

Areas covered: This review discusses the drugs in preclinical and early clinical trials for hyperuricemia, their mechanisms of action and available results. This article reviews a total of 10 novel agents: i) drugs in Phase II/III trials – arhalofenate (MBX201), AC201, RDEA group of drugs (including lesinurad), tranilast, ulodesine (BCX4208); and ii) drugs in Phase I trials, including levotofisopam, UR1102, KX1151, LC350189 and Marine Active.

Expert opinion: The goal of emerging therapies is to address the unsatisfactory control of serum uric acid in patients with symptomatic hyperuricemia such as those with gout, to provide better tolerability compared to traditional agents and minimize the risk of adverse events, especially in patients with comorbidities and the elderly. Some drugs like arhalofenate, ulodesine (BCX-4208) and lesinurad are in or have completed Phase II and Phase III trials. The growing knowledge about the urate transporters in the kidney have advanced our knowledge of pathophysiology of hyperuricemia and have led to the development of several new potential treatment options. Availability of new drugs will lead to better management and address the unmet need in patients with symptomatic hyperuricemia in the coming years.

Keywords:

• AC-201
• arhalofenate
• KX1151
• LC350189
• lesinurad
• levotofisopam
• Marine Active
• OAT4
• purine nucleoside phosphorylase
• RDEA
• tranilast
• ulodesine (BCX-4208)
• UR1102
• urate anion transporter 1

Declaration of interest

JA Singh is supported by grants from the Agency for Health Quality and Research Center for Education and Research on Therapeutics (AHRQ CERTs) U19 HS021110, National Institute of Arthritis, Musculoskeletal and Skin Diseases P50 AR060772 and U34 AR062891, National Institute of Aging U01 AG018947, National Cancer Institute U10 CA149950 and research contract CE-1304–6631 from the Patient Centered Outcomes Research Institute. JA Singh is also supported by the resources and the use of facilities at the VA Medical Center at Birmingham, Alabama, USA. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Notes

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