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Last Updated: December 18, 2025

Drugs in ATC Class M04AB


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Drugs in ATC Class: M04AB - Preparations increasing uric acid excretion

Market Dynamics and Patent Landscape for ATC Class M04AB — Preparations Increasing Uric Acid Excretion

Last updated: July 30, 2025


Introduction

The therapeutic space of ATC Class M04AB, encompassing drugs that promote uric acid excretion (uricosurics), remains integral to managing hyperuricemia and gout. Despite the advent of uric acid synthesis inhibitors like allopurinol and febuxostat, uricosuric agents retain relevance, especially in specific patient populations or where first-line therapies are contraindicated or ineffective. This article analyzes recent market dynamics, patent landscapes, and emerging innovation trends within this specialized domain, providing critical insights for industry stakeholders.


Market Overview and Drivers

Growing Prevalence of Gout and Hyperuricemia

Global epidemiological data indicate a rising prevalence of gout, notably driven by aging populations and increasing incidence of metabolic syndromes such as obesity, hypertension, and diabetes mellitus. The Global Burden of Disease study reports gout prevalence doubling over the past two decades, positioning uricosuric therapies as essential in managing this expanding patient population[1].

Limitations of Current Standard-of-Care

While xanthine oxidase inhibitors (e.g., allopurinol, febuxostat) form the backbone of gout management, their limitations include adverse effects like hypersensitivity reactions, cardiovascular risks, and contraindications in certain conditions. Uricosuric agents offer alternative mechanisms, providing options for patients intolerant or refractory to xanthine oxidase inhibition.

Emerging Therapeutic Needs

In recent years, the demand for more effective, safer, and patient-friendly uricosuric preparations has surged. Novel agents with improved pharmacokinetics, enhanced efficacy, and reduced side effects are actively sought to address unmet clinical needs.


Key Players and Patent Landscape

Established Agents and Their Patents

  • Probenecid: An older uricosuric, less frequently used today due to limited efficacy and tolerability concerns; patent expirations have facilitated generic competition.
  • Sulfinpyrazone: Similar status as probenecid, with patent expiration enabling cost-effective options but limited innovation.

Innovative Uricosuric Agents

Recent patent filings focus on next-generation uricosurics with improved selectivity and safety profiles.

  • Lesinurad (Zurampic): Approved in combination with xanthine oxidase inhibitors, with patents expiring around 2025, fueling generic entry and market competition [2].
  • Other Novel Agents: Multiple patent applications are active globally for compounds targeting URAT1 and other urate transporters to enhance uric acid excretion selectively.

Patent Strategy Trends

Innovators increasingly pursue patents on:

  • Selective URAT1 inhibitors: To minimize off-target effects.
  • Combination formulations: Uricosurics paired with anti-inflammatory agents or xanthine oxidase inhibitors.
  • Delivery systems: Extended-release formulations to improve adherence.

Market Dynamics Analysis

Patent Cliff and Generic Competition

The expiration timeline of key patents like probenecid and lesinurad opens avenues for generic manufacturers. This intensifies price competition but also pressures innovation, pushing firms to develop next-generation compounds with broader patent protection.

Pipeline and Investment Trends

Venture capital and pharmaceutical R&D entities are investing in urate transporter modulators, with several candidates advancing through clinical trials. This reflects optimism about unmet clinical needs and the potential for differentiation through improved safety profiles.

Regulatory Environment

Regulatory agencies such as the FDA and EMA facilitate expedited pathways for drugs addressing high unmet needs. Fast-track designations and orphan drug status may apply to novel uricosurics, incentivizing innovation.


Emerging Trends and Innovation Hotspots

Targeting Specific Urticuria Mechanisms

Agents targeting URAT1, GLUT9, and other urate transporters reflect a focused move toward mechanism-based therapies, promising improved efficacy and reduced adverse effects.

Combination Therapies

Combination regimens integrating uricosurics with anti-inflammatory agents or other urate-lowering therapies aim to provide comprehensive gout control, possibly reducing pill burden and improving adherence.

Personalized Medicine Approaches

Pharmacogenomic profiling guides therapy choices, especially in patients with contraindications or genetic predispositions affecting drug metabolism or transporter function.


Future Outlook and Market Opportunities

The uricosuric segment within M04AB is poised for growth owing to unmet clinical needs and patent expirations of older agents. Innovation focusing on transporter selectivity, safety, and ease of use will be pivotal. Collaborations between pharma and biotech firms to develop combination and targeted therapies are likely to catalyze market expansion.


Key Takeaways

  • Market expansion for uricosuric agents persists, driven by rising gout prevalence and unmet therapeutic needs.
  • Patent expiries of early agents create both competitive pressure and licensing opportunities.
  • Innovation is concentrated on transporter-specific drugs, combination formulations, and improved delivery systems.
  • Regulatory pathways favor novel agents with demonstrable safety and efficacy benefits, facilitating faster market entry.
  • Strategic IP management and pipeline development remain crucial for firms aiming to secure competitive advantages in this niche.

FAQs

Q1: How does patent expiry influence the market for uricosuric agents?

Patent expiries open the market to generic competition, reducing prices and increasing accessibility. Nonetheless, they also pressure innovators to develop next-generation drugs with novel mechanisms or formulations to maintain exclusivity.

Q2: What are the main challenges in developing new uricosuric agents?

Challenges include ensuring high selectivity for urate transporters such as URAT1, minimizing adverse effects (e.g., kidney stones), achieving favorable pharmacokinetics, and demonstrating clear clinical benefits over existing therapies.

Q3: Which regulatory incentives support innovation in the uricosuric segment?

Fast-track designations, orphan drug status, and priority review pathways are available for agents addressing significant unmet needs, accelerating approval timelines.

Q4: Are combination therapies a strategic trend in the uricosuric market?

Yes. Combining uricosurics with anti-inflammatory agents or other urate-lowering drugs enhances therapeutic efficacy, addresses multiple disease facets, and improves patient compliance.

Q5: What role does personalized medicine play in this therapeutic arena?

Genetic profiling can inform drug selection, optimize dosing, and improve safety, especially considering transporter polymorphisms impacting uricosuric drug efficacy.


References

[1] Neogi, T. et al. (2020). Gout Epidemiology and Lifestyle Factors. Nature Reviews Rheumatology.
[2] U.S. FDA. (2022). Patent expiration dates for lesinurad and related patent filings.

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