Effect of canakinumab on clinical and biochemical parameters in acute gouty arthritis: a meta-analysis
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Inflammopharmacology
REVIEW
Effect of canakinumab on clinical and biochemical parameters in acute gouty arthritis: a meta‑analysis Monalisa Jena1 · Amruta Tripathy1 · Archana Mishra2 · Rituparna Maiti1 Received: 5 July 2020 / Accepted: 28 August 2020 © Springer Nature Switzerland AG 2020
Abstract Background Targeted anti-IL-1β therapy may be a valuable option for the management of gouty arthritis. The present metaanalysis has evaluated the effect of canakinumab, an anti-IL-1β monoclonal antibody in gouty arthritis. Methods A standard meta-analysis protocol was developed and after performing a comprehensive literature search in MEDLINE, Cochrane, and International Clinical Trial Registry Platform (ICTRP), reviewers assessed eligibility and extracted data from three relevant articles. A random-effects model was used to estimate the pooled effect size as the mean difference in Visual Analouge Scale (VAS) score, serum hsCRP, serum Amyloid A, and risk ratio for global assessment between the groups. Quality assessment was done using the risk of bias assessment tool and summary of findings was prepared using standard Cochrane methodology with GradePro GDT. Results Treatment with canakinumab showed a mean reduction of VAS score by 14.59 mm [95% CI − 19.42 to − 9.77], serum hsCRP by 15.36 mg/L [95% CI 1.62–29.11], serum Amyloid A by 67.18 mg/L [95% CI 17.06–117.31], and improvement in patient global assessment (RR = 1.478; 95% CI 1.29–1.67) and physician global assessment (RR = 1.44; 95% CI 1.28–1.61). The probability that future studies may have a mean difference in VAS score less than zero has been calculated to be 27.3% using a cumulative distribution function (CDF) calculator. Conclusion This meta-analysis shows the beneficial effect of canakinumab over triamcinolone by reducing VAS score, serum hsCRP, serum amyloid A, and improvement in global assessments in acute gouty arthritis. Keywords Canakinumab · Gouty arthritis · hsCRP · Serum amyloid A · VAS
Introduction Gout is an autoinflammatory disease associated with increased blood levels of urate and subsequent deposition of monosodium urate crystals in and around joints (Martinon 2010). The burden of gout is substantial as it is one * Rituparna Maiti [email protected] Monalisa Jena [email protected] Amruta Tripathy [email protected] Archana Mishra [email protected] 1
Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, Odisha, India
Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
2
of the most common causes of inflammatory arthritis with an increasing prevalence rate in industrialised countries (Arromdee et al. 2002; Trifiro et al. 2013). Gout is also an independent risk factor for cardiac and all-cause morbidity and mortality (Clarson et al. 2015; Kleinman et al. 2007; Kuo et al. 2010; Scire et al. 2013). The symptoms and chronicity of the disease deeply impact patients’ quality of life and workabili
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