Abstract

BackgroundDotinurad is a novel selective urate reabsorption inhibitor (SURI) which reduces serum uric acid levels by selectively inhibiting urate transporter 1 (URAT1). This study was intended to verify the efficacy and safety of dotinurad following treatment for 34 or 58 weeks in hyperuricemic patients with or without gout.MethodsThis long-term study had an open-label design with dose escalation. The dose of dotinurad started at 0.5 mg/day and was increased progressively to 2 mg/day. If the serum uric acid level of patients did not reach ≤ 6 mg/dL at week 14, the dose was increased to 4 mg/day. The primary endpoint was the percent change in serum uric acid level from the baseline to each visit.ResultsAt a dose of 2 mg, serum uric acid levels at week 34 and 58 were reduced from the baseline by 46.73% and 47.17%, respectively; at 4 mg, the respective values were 54.92% and 57.35%. At week 34 and 58, the percentages of patients achieving a serum uric acid levels ≤ 6.0 mg/dL with 2-mg dose were 89.11% and 91.30%, respectively; with 4 mg, the respective rates were 97.50% and 100.00%. In addition, the incidences of adverse events and adverse drug reactions were 65.2% and 21.8%, respectively.ConclusionDotinurad at doses of 2–4-mg sufficiently reduced serum uric acid levels in hyperuricemic patients with or without gout, and its efficacy and safety were verified for long-term administration.ClinicalTrials.gov Identifier: NCT03006445

Highlights

  • In Japan, hyperuricemia is defined as a serum uric acid level > 7.0 mg/dL; this causes urate crystal deposition diseases such as gouty arthritis and gouty tophus [1]

  • Dotinurad was administered at an initial dose of 0.5 mg/day for 2 weeks followed by 1 mg/day for 4 weeks and 2–4 mg/day as a maintenance dose for 28 or 52 weeks, to examine efficacy and safety in patients with hyperuricemia with or without gout

  • Serum uric acid levels gradually decreased from week 2 and remained stable at ≤ 6.0 mg/dL after administration of the maintenance dose

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Summary

Introduction

In Japan, hyperuricemia is defined as a serum uric acid level > 7.0 mg/dL; this causes urate crystal deposition diseases such as gouty arthritis and gouty tophus [1]. In the Japanese guidelines for the management of hyperuricemia and gout, the need for pharmacological therapy in hyperuricemic patients is determined by the serum uric acid level, with a target of maintaining the serum uric acid level ≤ 6.0 mg/dL, in consideration of the solubility of urate crystals [1]. Long periods of treatment for hyperuricemia and gout may be required to control serum uric acid levels, using both lifestyle modification and antihyperuricemic drugs. This study was intended to verify the efficacy and safety of dotinurad following treatment for 34 or 58 weeks in hyperuricemic patients with or without gout. Conclusion Dotinurad at doses of 2–4-mg sufficiently reduced serum uric acid levels in hyperuricemic patients with or without gout, and its efficacy and safety were verified for long-term administration.

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