The Gout Narrative Keeping Patients Sick and What Crystalys Therapeutics Is Doing Differently
July 23, 2026
Most people still think gout is a lifestyle condition caused primarily by diet. But this belief is a big reason patients have been underserved for decades. In this episode of Power to the Patients, Brandon Li sits down with James Mackay, CEO and co-founder of Crystalys Therapeutics, to explore what gout patients really need. They unpack what went wrong with Zurampic, why Dotinurad’s profile gives Crystalys Therapeutics a reason to come back to gout and how better trial design could finally move the field beyond old assumptions.
For decades, gout has often been framed as a disease caused by lifestyle choices. This episode reframes the conversation entirely.
Gout is often treated solely as a lifestyle problem. James Mackay calls that a myth.
In this episode of Power to the Patients, host Brandon Li sits down with James, CEO and co-founder of Crystalys Therapeutics, to unpack why gout has been misunderstood, under-prioritized, and under-innovated for decades. They also explore how biotech teams learn from setbacks, choose the right assets, design trials around patient reality, and return to an overlooked disease when the work is not finished.
What You’ll Learn:
- Why the “gout is caused by diet” narrative has done real damage to patient care
- How poor uric acid excretion drives the majority of gout cases
- What James Mackay learned from leading the Zurampic program through Phase 3 and approval
- Why renal toxicity became such an important lesson in URAT1 inhibitor development
- How Dotinurad’s smoother 12- to 14-hour profile changes the safety conversation
- Why Crystalys is positioning Dotinurad for patients who are not controlled on first-line therapies
- What it takes to run multiple clinical programs with a small, experienced biotech team
About James:
James Mackay is the CEO and co-founder of Crystalys Therapeutics, a clinical-stage biopharmaceutical company focused on transforming treatment options for people living with gout. Before Crystalys, James spent 30 years at AstraZeneca, where he worked across life sciences and business development before moving into biotech leadership. He previously led Ardea Biosciences after AstraZeneca acquired the company, taking Zurampic through Phase 3 development, regulatory submission, and approval. Today, James is applying those lessons to Dotinurad, Crystalys Therapeutics’ lead candidate and a next-generation oral URAT1 inhibitor being developed for patients with gout who remain uncontrolled on existing therapies.
Episode Resources:
- James Mackay on LinkedIn: http://linkedin.com/in/james-m-mackay
- Crystalys Therapeutics Website: https://crystalystx.com/
- Brandon Li on LinkedIn: https://www.linkedin.com/in/brandonhli/
- With Power Website: https://www.withpower.com/
- Power on LinkedIn https://www.linkedin.com/company/withpower/