Could Lesinurad Raise the Low Profile of Gout?

The new selective uric acid re-absorption inhibitor lesinurad is showing promise against gout in combination with febuxostat or allopurinol for gout patients who fail to reach uric acid targets with monotherapy.

In this video interview, speaking at the recent American College of Rheumatology annual meeting in Boston, David Ginkel, who is Senior Medical Affairs Leader of AstraZeneca's lesinurad program, shared with Rheumatology Network the company's vision that (if approved) lesinurad, the first new option for gout in many years, could offer an opportunity to raise consciousness about gout as a truly serous threat to health.

The questions:

•   Could you describe your role in the lesinurad program please?

•   What is lesinurad?

•   How does it work physiologically?

•   In your abstract you described two studies, CLEAR1 and CLEAR2. Why did we need two studies? ... Do you feel that results of one of them is more relevant to doctors in the United States?

•   Who do you think, based on the studies, is most likely to respond to the drug?

•   A well-known problem is that primary care doctors are not treating to guidelines. How do you think lesinurad is going to help with this if it's adding another drug?

•   One of the results was that you saw a 6-fold increased risk of kidney stones at the 400-mg dose in CLEAR2. What did you say about this in your presentation?

Key quotes:

We know that 40-70% of patients don't respond to a stable dose of allopurinol ... Since we know that most patients don't achieve their SUA (serum uric acid) goals of getting below 6 mg/dl, there's a high burden for these patients ... If they're not treated aggressively [this] can have long term consequences.

There hasn't been much innovation in this area ... What we're seeing here at ACR and other congresses is more abstracts, more science, which is really exciting to us.