[EULAR HL 2023] Metabolic & crystal arthropathies

Author: Juan C Sarmiento-Monroy

Mccormick et al. (OP0258) evaluated the incident gout risk among metformin-treated patients with type 2 diabetes initiating SGLT2i vs. other second-line treatments in a population-based cohort study using administrative health data for nearly all residents of British Columbia, Canada. SGLT2i initiation among metformin-treated patients with type 2 diabetes was associated with a substantially lower risk of incident gout, compared with any other 2nd-line options.

Andrés et al. (POS0367studied the distribution of comorbidities by sex in hospitalized patients with gout in Spain in a retrospective, nation-based cohort study. They analyzed 192,037 admissions, 5.47% (n=10,512) with gout as the primary diagnosis. Women with gout were significantly older and more likely to suffer from heart failure, obesity, urinary infection, and diabetes. 

Hammer et al. (OP0296explored the change of crystal depositions assessed by ultrasound and dual-energy computer tomography (DECT) for two years, and the associations between depositions and the occurrence of flare during the first year of ULT in 209 patients included in the NOR-Gout study. The amount of crystal depositions in both imaging modalities decreased substantially during ULT as did the occurrence of flare. Baseline US and DECT depositions predicted flare during follow-up. This study highlights the importance of a treat-to-target procedure of serum uric acid (sUA) reduction to reduce both depositions and flares. 

Botson et al. (POS0513studied prespecified PROs and gout-related clinical measures through month 12 of pegloticase + MTX/PBO co-therapy in 152 patients (MIRROR trial). Pegloticase treatment resulted in meaningful improvements in both clinical measures and quality of life in patients with uncontrolled gout. Patients co-treated with MTX experienced greater improvements in HAQ-Pain and Health scores after 52 weeks of therapy, likely reflective of the higher urate-lowering response rate observed in the presence of MTX immunomodulation. 

Keenan et al. (OP0295) presented data about AR882, a novel, potent, and selective uric acid transporter 1 (URAT1) inhibitor in development for the treatment of gout. They presented the results of a phase 2b randomized, double-blinded, and placebo-controlled trial. This 12-week study evaluated the safety, tolerability, and efficacy of AR882 vs. PBO in 140 patients with gout.The majority of patients receiving AR882 had achieved sUA levels below 5 or 4 mg/dL and was well tolerated. This study suggests that AR882 may offer improved efficacy with acceptable safety compared to existing therapies for gout.


Juan C Sarmiento-Monroy

Juan C. is a Rheumatologist and clinical research fellow at the Hospital Clinic of Barcelona. His main research interests include the validation of biomarkers in RA-ILD and the development of digital tools for patients with SLE. Juan C. is a member of the EMEUNET Newsletter Sub-Committee.

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