Emerging therapies for gout

Rheum Dis Clin North Am. 2014 May;40(2):375-87. doi: 10.1016/j.rdc.2014.01.013. Epub 2014 Feb 20.

Abstract

Over the past decade much has been learned about the mechanisms of crystal-induced inflammation and renal excretion of uric acid, which has led to more specific targeting of gout therapies and a more potent approach to future management of gout. This article outlines agents being developed for more aggressive lowering of urate and more specific anti-inflammatory activity. The emerging urate-lowering therapies include lesinurad, arhalofenate, ulodesine, and levotofisopam. Novel gout-specific anti-inflammatories include the interleukin-1β inhibitors anakinra, canakinumab, and rilonacept, the melanocortins, and caspase inhibitors. The historic shortcomings of current gout treatment may, in part, be overcome by these novel approaches.

Keywords: Febuxostat; Gout; Interleukin-1 inhibitor; Lesinurad; Melanocortin; Pegloticase; Ulodesine; Urate-lowering therapy.

Publication types

  • Review

MeSH terms

  • Acetamides / therapeutic use
  • Adrenocorticotropic Hormone / therapeutic use*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents / therapeutic use*
  • Benzodiazepines / therapeutic use
  • Febuxostat
  • Gout / drug therapy*
  • Gout Suppressants / therapeutic use
  • Humans
  • Imino Furanoses / therapeutic use
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use
  • Interleukin-1beta / antagonists & inhibitors*
  • Melanocortins / therapeutic use*
  • Phenylacetates / therapeutic use
  • Polyethylene Glycols
  • Pyrimidinones / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use
  • Thiazoles
  • Thioglycolates / therapeutic use
  • Triazoles / therapeutic use
  • Urate Oxidase
  • Uricosuric Agents / therapeutic use*

Substances

  • Acetamides
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Gout Suppressants
  • Imino Furanoses
  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1beta
  • Melanocortins
  • Phenylacetates
  • Pyrimidinones
  • Recombinant Fusion Proteins
  • Thiazoles
  • Thioglycolates
  • Triazoles
  • Uricosuric Agents
  • lesinurad
  • Febuxostat
  • Benzodiazepines
  • arhalofenate
  • canakinumab
  • Polyethylene Glycols
  • rilonacept
  • Adrenocorticotropic Hormone
  • Urate Oxidase
  • ulodesine
  • Pegloticase
  • tofisopam