Canakinumab's Effect Against Subsequent Gout Flares and High‐Sensitivity C‐Reactive Protein Levels: A Causal Mediation Analysis
Primary result · Gout flare, overall cohortResult — go to the resultHazard ratio 0.50 95% CI 0.37–0.68Authors' conclusion
The first 3-month reduction in hsCRP level was not a good biomarker for canakinumab's protective effect on future gout flares in the overall cohort.
Study context
- Population
- Canakinumab Anti-Inflammatory Thrombosis Outcome Study participants, overall and stratified by prevalent gout at baseline9,221 without and 747 with prevalent gout
- Comparison
- Canakinumab vs placebo; mediation through 3-month change in log high-sensitivity C-reactive protein (hsCRP)
- Primary endpoint
- Gout flares; proportion of canakinumab's effect mediated by 3-month change in log hsCRP
Methodological detailspost hoc, causal mediation analysis, Cox or Weibull regression, stratified by prevalent gout at baseline
- Post hoc
- Causal mediation analysis
- Cox or Weibull regression
- Stratified by prevalent gout at baseline
Primary result
Gout flare, overall cohort
Hazard ratio
0.50
95% CI 0.37–0.68
Canakinumabvs Placebo
HR 0.50 (95% CI 0.37–0.68)
As reported in the abstract
- Proportion explained by mediated effect through hsCRP reduction in first 3 months
- 6%
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Gout flare, prevalent-gout subgroup | 0.58 (0.36–0.95) | |
| 0.20.5125Hazard ratio (log scale) |
- Gout flare, prevalent-gout subgroup — Proportion explained by mediated effect through hsCRP reduction
- 31%
- Gout flare, prevalent-gout subgroup — Proportion mediated, Weibull analysis
- 47%
Gout flare, subgroup without prevalent gout
- Indirect effect via hsCRP reductions unclear
Original publication
Canakinumab's Effect Against Subsequent Gout Flares and High‐Sensitivity C‐Reactive Protein Levels: A Causal Mediation Analysis. Arthritis Care Res (Hoboken). Published 26 November 2022. doi:10.
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