The gout treatment landscape is poised for significant advancements, with over 30 drugs currently in the pipeline, according to a new report. These emerging therapies offer novel approaches to managing hyperuricemia and inflammation, potentially improving outcomes for patients suffering from this painful condition.
Novel Xanthine Oxidase Inhibitors
LG Chem's Tigulixostat (LC350189) is a xanthine oxidase inhibitor in Phase III clinical trials. Unlike traditional purine analog inhibitors like allopurinol, Tigulixostat has a novel structure and has demonstrated efficacy in reducing uric acid levels with a favorable safety profile in Phase II studies. Xanthine oxidase inhibitors work by targeting the reduction of uric acid in purine metabolism, inhibiting the activity of xanthine oxidase.
Urate Transporter Inhibitors
Shanton Pharma is developing SAP-001, an investigational urate transporter inhibitor, for refractory and tophaceous gout. SAP-001 targets uric acid transporter 1 (URAT1) to lower urate levels in patients who have not responded adequately to allopurinol or febuxostat. This drug is currently in Phase II development.
InventisBio's D-0120, a selective uric acid transporter (URAT1) inhibitor, is also in Phase II trials. Preclinical studies suggest that D-0120 may have a more potent serum uric acid-reducing effect than lesinurad, with less toxicity and a wider therapeutic window. In vitro studies showed D-0120's inhibitory activity is 150-fold more potent than lesinurad. A Phase I clinical trial demonstrated good efficacy and an excellent safety profile.
Anti-inflammatory Approaches
Jiangsu Atom Bioscience and Pharmaceutical is developing ABP-745, a small molecule drug with anti-inflammatory properties, for the treatment of acute gout. Currently in Phase I clinical trials, ABP-745 is designed for oral administration. The first trial was initiated on January 3, 2024, in the United States.
Current Treatment Landscape
Gout is a common form of inflammatory arthritis caused by hyperuricemia, leading to the deposition of monosodium urate crystals in joints and tissues. Current treatments include xanthine oxidase inhibitors (e.g., allopurinol, febuxostat) to reduce uric acid production and uricosuric agents (e.g., probenecid, lesinurad) to enhance uric acid excretion. Anti-inflammatory drugs like NSAIDs, colchicine, and corticosteroids are used to manage acute flares.
Despite available treatments, many patients continue to experience frequent flares and progressive joint damage, highlighting the need for novel therapies that can more effectively lower serum uric acid levels and reduce inflammation.
Companies Involved
Several companies are actively involved in developing new gout therapies, including:
- LG Chem
- Shanton Pharma
- InventisBio
- Jiangsu Atom Bioscience and Pharmaceutical
- Arthrosi Therapeutics
These companies are exploring various approaches, including novel inhibitors, biologics, and gene therapies, to address the unmet needs in gout management.
