Background:The adherence to lowering therapy for gout is low, including in chronic severe gout. Whether interleukin 1 inhibitors may contribute to better adherence is unknown.Objectives:To compare adherence to urate-lowering therapy in patients with severe gout who received canakinumab versus patients who received standard anti-inflammatory therapy (NSAIDs, glucorticoids, colchicine).Methods:Of the 513 patients with gout observed at the V.A. Nasonova Research Institute of Rheumatology, Moscow from 2013 to 2014 y 247 patients with the most severe gout, requiring regular symptomatic treatment, were selected. Of these, 25 patients (3 (12%) women and 22 (88%) men), the average age of 54.5 ± 12.7 g, received (at least 1) canakinumab injection of 150 mg subcutaneously as a symptomatic therapy, the remaining 222 patients (men) mean age 51.9 ± 11.4 g. received standard anti-inflammatory therapy (colchicine (55% of patients), glucorticoids (5%), NSAIDs (40%), or a combination of these (3%). On average, after 4,8 ± 1.7 years, a comparative analysis of adherence to reducing therapy was carried out, as well as the need for anti-inflammatory therapy and assessment of adherence according to the Score compliance on the scale of the Moriscy-Green patients who received and did not receive canakinumab.Results:Evaluation was available in 180 patients (16 who received canakinumab and 164 who received standard anti-inflammatory therapy) who were initially given reducible therapy. 11 patients died (2 patients (8%) who received canakinumab and 9 (4%) patients on standard anti-inflammatory therapy), 56 patients (7 (28%) and 49 (22%), respectively) were not available for observation. Adherence to urate-lowering therapy was better in patients who received canakinumab (see table 1).Table 1.Score compliance on the scale of the Moriscy-GreenAdherence to therapyPatients receiving canakinumab, (n %)Patients receiving standard anti-inflammatory therapy, (n %)р=High (> 4 points)14 (87)83 (51)0,07Moderate (3 points)2 (13)46 (28)0,13Low (2 and <points)035 (21)0,03The likelihood of maintaining the target uric acid level when taking urate-lowering drugs in patients who previously received canakinumab was higher (12 patients (75%) who received canakinumab and 32 (20%) patients received standard anti-inflammatory therapy (p = 0.005).During the year preceding the analysis, there were no acute attacks of arthritis in 12 (75%) patients who received canakinumab and 46 (28%) patients received standard anti-inflammatory therapy (p = 0.002).132 patients who previously received regular anti-inflammatory therapy and received standard anti-inflammatory therapy and 1 patient (1 attack) (p = 0.005) who previously received canakinumab took anti-inflammatory drugs over the past year due to the development of exacerbations (an average of 3 seizures per year): NSAIDs (54%) or colchicine (46%).Conclusion:Therapy with interleukin 1 Kanakinumab may contribute to a better adherence to lowering therapy and isidentified with a lesser need for symptomatic therapy with long-term follow-up.Disclosure of Interests: :Maxim Elisеev Speakers bureau: Novartis, Menarini Group, Alium, Olga Sheliabina: None declared
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