New developments in gout

Abstract

PURPOSE OF REVIEW: Gout is the most common type of inflammatory arthritis. This review summarizes the most recent studies on newer therapeutics, disease management strategies and treatment recommendations. RECENT FINDINGS: There are several new therapeutic agents being investigated both for the management of the acute gout symptoms, targeting interleukin-1beta, as well as urate-lowering therapies including uricase and inhibitors of renal urate transporter proteins. Interventions led by pharmacists and nurses, which include patient education, lifestyle advice, monitoring and titration of urate-lowering medications have been implemented to improve gout management. Recently, the American College of Rheumatology has published guidelines for nonpharmacologic and pharmacologic therapeutic approaches for hyperuricemia and acute gouty arthritis. SUMMARY: New therapeutic agents targeting the mechanism of inflammation (IL-1beta) are under investigation. In addition, new urate-lowering medications to be used alone or in combination with allopurinol are undergoing rigorous evaluation to use for patients not responding to or unable to take current therapies. There is also increasing interest in redesigning clinical care to improve patient education, self-management training and urate-lowering medication titration. Although we await results of these investigations, the American College of Rheumatology treatment guidelines provide a framework for clinicians in order to provide optimal gout care.