Gaffo AL, Saag K, Doyle AJ, et al. - Addition of denosumab (a monoclonal antibody targeting the receptor activator of nuclear factor kappa-B ligand - RANKL) to intensive urate-lowering therapy (ULT) did not provide additional benefit in the treatment of gouty bone erosion.

• This pilot study included 20 gouty bone erosion cases treated with denosumab added to intensive ULT, or intensive ULT alone.

• After one year of follow-up, no interval change (from baseline to 12 months) in computed tomography erosion score was evident in either the denosumab/ULT or ULT alone group.

• Remarkable decline of serum C-terminal telopeptide was evident in the denosumab/ULT group, but there was no difference in other secondary outcomes (patient reported outcomes of pain and function) between groups.

• Two severe adverse events occurred: one patient suffered atrial fibrillation (on denosumab/ULT) and another atrial flutter (on ULT alone).