Rheumatology Month in Review: March 2025

March brought significant advancements in rheumatology, spanning gout, psoriatic arthritis (PsA), and fibromyalgia. In gout, SAP-001 from Shanton Pharma showed best-in-class efficacy in a phase 2b trial, with most patients achieving target uric acid levels by month three. XORTX continued its discussions with the FDA on oxypurinol-based XORLO, a potential new treatment for hyperuricemia. Meanwhile, new epidemiological data linked tuberculosis to a 42% increased risk of gout, likely due to medication-induced disruptions in uric acid metabolism.

In PsA, the POETYK PsA-2 trial reinforced the benefits of deucravacitinib, a TYK2 inhibitor, in reducing symptoms and improving quality of life, even among patients with prior TNF inhibitor exposure. A separate analysis found comparable cardiovascular safety across biologics like ustekinumab, adalimumab, etanercept, and secukinumab, providing reassurance on long-term treatment risks.

Fibromyalgia research explored nontraditional therapies, including select Cannabis sativa terpenes such as geraniol and linalool, which showed promise in reducing pain via the A2aR mechanism. Additionally, a clinical trial demonstrated that M1-repetitive transcranial magnetic stimulation (rTMS) reduced fibromyalgia pain for up to eight weeks, with functional improvements lasting up to 16 weeks.

Novel Therapies Show Promise for Gout

SAP-001 Demonstrates “Best in Class” Data for Gout With Hyperuricemia Refractory to SOC XOI Therapy

SAP-001, a novel urate-lowering agent, demonstrated best-in-class efficacy in a Phase 2b trial, with a majority of patients achieving target serum uric acid levels by Month 3. The treatment showed potential for addressing hyperuricemia refractory to standard xanthine oxidase inhibitor (XOI) therapy.

Oxypurinol Formulation May Be Adapted for Gout Treatment

XORTX is advancing its oxypurinol-based formulation, XORLO, for the treatment of hyperuricemia in gout, with ongoing discussions with the FDA. The novel formulation aims to enhance safety and efficacy compared to existing xanthine oxidase inhibitors.

Patients With Tuberculosis at Increased Risk of Gout A population-based study found that patients with a history of tuberculosis have a 42% increased risk of developing gout. The association may be linked to the metabolic effects of TB treatment, particularly medications that influence uric acid regulation.

New Pain Management Strategies for Fibromyalgia

Cannabis Sativa Terpenes Show Promise in Improving Post-Operative, Fibromyalgia Pain Preclinical research suggests that specific Cannabis sativa terpenes, including geraniol and linalool, may alleviate fibromyalgia-related pain through A2a receptor modulation. These findings highlight the potential of terpene-based therapies as adjunctive pain management strategies.

TMS Reduces Pain, Yields Functional Improvements in Women With Fibromyalgia

A clinical study demonstrated that M1-repetitive transcranial magnetic stimulation (rTMS) significantly reduced fibromyalgia pain for up to eight weeks, with sustained functional improvements lasting 16 weeks. The findings support rTMS as a noninvasive neuromodulatory option for fibromyalgia management.

Data Updates in Psoriatic Arthritis

Deucravacitinib Improves PsA Symptoms and Quality of Life in POETYK PsA-2 The POETYK PsA-2 trial showed that deucravacitinib, a selective TYK2 inhibitor, led to significant symptom improvement and quality-of-life benefits in patients with active psoriatic arthritis. Efficacy was observed even in those with prior inadequate response to TNF inhibitors.

Ustekinumab, Other Biologics for PsA and PsO Have Similar Cardiovascular Safety A comparative safety analysis found that ustekinumab, adalimumab, etanercept, and secukinumab exhibited similar cardiovascular risk profiles in patients with psoriatic arthritis and psoriasis. These findings provide reassurance regarding the long-term cardiovascular safety of biologic therapies in these populations.