Work

Use of firsekibart for acute gouty arthritis in a maintenance hemodialysis patient with multiple high-risk comorbidities: a case report

Year: 2026

Type: article

Abstract: Objective: To describe the clinical course of Firsekibart treatment for acute gouty arthritis in a 51-year-old patient receiving maintenance hemodialysis with multiple high-risk comorbidities, focusing on the temporal relationship among dialysis, drug administration and the timing of symptom changes. This report adds to the limited evidence on using Firsekibart, a novel fully human monoclonal antibody targeting IL-1β, in patients receiving maintenance hemodialysis. Methods: We retrospectively reviewed the patient's underlying diseases, acute gout manifestations, timing of Firsekibart administration relative to hemodialysis, visual analogue scale (VAS) pain scores, body temperature, and inflammatory markers. The clinical course was interpreted in the context of available clinical evidence on Firsekibart, experience with other IL-1 pathway agents in patients with advanced chronic kidney disease and/or receiving dialysis, and monoclonal antibody pharmacokinetics. Results: Pain relief was documented 6-7 h after Firsekibart administration, before the first post-dose hemodialysis session; however, tramadol and topical flurbiprofen had been administered within the preceding hour and may have contributed to the observed improvement. No worsening or rebound of pain was observed on the day of dialysis or the following day. No immediate hypersensitivity reaction was observed during the early post-dose period. Follow-up continued through 24 June 2026 (35 days post-dose), no gout flare recurred; however, biliary symptoms and a febrile episode with suspected catheter-related bloodstream infection occurred, with uncertain relationships to Firsekibart. Conclusion: In this maintenance hemodialysis patient, gout-related pain improved before the first post-dose dialysis session and did not rebound after dialysis. However, this single case, without pre- or post-dialysis Firsekibart concentration measurements, cannot establish causality or determine the effect of hemodialysis on drug exposure.

Source: Frontiers in Pharmacology

DOI: 10.3389/fphar.2026.1928098

Authors: Jiaqi Chen, Ruoyu Tong, Meng Shen, Weidong Zhang, Yuanhang Huang

Institutions: Guangdong Pharmaceutical University, First Affiliated Hospital of Guangdong Pharmaceutical University

Language: English

Topic: Gout, Hyperuricemia, Uric Acid

Subfield: Nephrology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801