Authors
Zhaoxia Li, Yanling Jie, Yi Zhou, Yi Li
Published in
Translational andrology and urology. Volume 15. Issue 6. Pages 224. Jun 30, 2026. Epub Jun 25, 2026.
Abstract
The management of acute gout flares in elderly patients with multiple comorbidities remains a significant clinical challenge. Although interleukin-1β (IL-1β) inhibitors are recommended for refractory gout when conventional therapies are unsuitable, evidence remains limited regarding their use in patients with active malignancy and moderate-to-severe renal impairment. This case addresses the knowledge gap in balancing potent anti-inflammatory therapy with complex oncological and renal risks.
We report a case of a 73-year-old male patient with refractory gout, a disease duration exceeding 20 years, and extensive tophus formation. The patient was concomitantly diagnosed with acinar adenocarcinoma of the prostate, stage 3 chronic kidney disease (CKD), coronary artery disease, and grade 3 hypertension. Due to recurrent acute gout flares, impaired renal function, and a high risk of bleeding, standard anti-inflammatory therapeutic options were contraindicated. After a comprehensive assessment of the potential risks and benefits, treatment was initiated with firsekibart, a novel fully human monoclonal antibody targeting IL-1β, administered as a single 200 mg subcutaneous injection, in combination with a short course of low-dose glucocorticoids. Urate-lowering therapy with febuxostat was subsequently introduced. Marked relief of joint pain and swelling was observed within 24 hours of treatment. During the 3-month follow-up period, inflammatory markers improved substantially, with high-sensitivity C-reactive protein decreasing from 62.36 to 0.9 mg/L. Target serum urate levels were achieved (444.9 µmol/L), and renal function showed improvement, as evidenced by an increase in the estimated glomerular filtration rate from 36.4 to 44.9 mL/min/1.73 m2. No evidence of tumor progression, serious infections, or major cardiovascular adverse events was observed in the follow-up period.
This case suggests that firsekibart may provide rapid and effective inflammation control in high-risk gout populations where standard treatments are limited. These findings highlight the potential of IL-1β targeted therapy as a precision medicine approach for complex patients; however, larger prospective studies are required to validate the long-term oncological and renal safety profile of firsekibart in this population.
PMID:
42436784
Bibliographic data and abstract were imported from PubMed on 12 Jul 2026.
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