Lesinurad for the treatment of hyperuricaemia in people with gout

ABSTRACT

Introduction: Gout is a common form of inflammatory arthritis caused by deposition of monosodium urate crystals. The central strategy for effective long-term management of gout is serum urate lowering. Current urate-lowering drugs include both xanthine oxidase inhibitors and uricosuric agents. Lesinurad is a URAT1 inhibitor that selectively inhibits urate rebsorption at the proximal renal tubule. Lesinurad 200mg daily in combination with a xanthine oxidase is approved for urate-lowering therapy in patients with gout.

Areas covered: The published literature was searched using Pubmed and additional information was obtained from publically available regulatory documents. Pre-clinical data and clinical trials of lesinurad are described. Serum urate-lowering efficacy and effects on other clinical endpoints are discussed. Adverse event data, focusing on renal safety are also presented.

Expert opinion: Lesinurad is an effective urate-lowering drug that has a generally acceptable safety profile when used at 200mg daily dosing in combination with a xanthine oxidase inhibitor. The recent approval of fixed dose combination pills of lesinurad with allopurinol is an important step in improving adherence and reducing risk of renal adverse events. It remains to be seen if this therapy will provide additional benefit for gout management above improved use of widely available generic therapies.

KEYWORDS:

• Lesinurad
• urate
• gout
• kidney

Declaration of interest

P C Robinson has received research funding and speaker fees from AstraZeneca and consulting and speaking fees from Menarini and Novartis. N Dalbeth has received consulting fees, speaker fees or grants from Takeda, Menarini, Teijin, Pfizer, Andrea Biosciences, AstraZeneca, Horizon and Cymabay. N Dalbeth was the principal investigator for the CRYSTAL phase III study and was an investigator on CLEAR2 and LIGHT phase III trials. 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. Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.