title: [New therapeutic options for gout].
abstract: Chronic hyperuricemia and acute arthritis in severe gouty patients can be difficult to manage, in particular in patients with renal failure or with history of cardio vascular conditions. Hopefully, new drugs have been approved or will emerge, and will help to overcome these situations. Febuxostat has been recently approved in France for the treatment of chronic hyperuricemia in conditions where urate deposition has already occurred. Febuxostat is a novel non-purine, selective inhibitor of xanthine oxidase, metabolized and excreted by the liver, so no dose adjustment appears to be necessary in patients with mild-to-moderate renal impairment. Other novel hypouricemic drugs are the PEG-uricase (pegloticase), recently approved by the FDA, and a novel uricosuric drug (RDEA594), which is currently under development. The discovery that interleukin 1β (IL- β) plays a key role in the pathogenesis of acute attacks of gout has prompted to assess the efficacy of IL-1 β blockers in patients with acute gout. Biologic agents that inhibit IL-1 β such as canakinumab, rilonacept and anakinra have shown promising results for the treatment of gouty arthritis.
authors.affiliation: Université Paris 7, Assistance-publique-Hôpitaux de Paris, hôpital Lariboisière, fédération de rhumatologie, UFR médicale, 2, rue Ambroise-Paré, 75475 Paris Cedex 10, France. pascal.richette@lrb.aphp.fr
authors.forename: Pascal
authors.initials: P
authors.lastname: Richette
authors.forename: Sébastien
authors.initials: S
authors.lastname: Ottaviani
authors.forename: Thomas
authors.initials: T
authors.lastname: Bardin
mesh_terms: D000493:Allopurinol / Q000009:adverse effects / Q000627:therapeutic use; D018849:Controlled Clinical Trials as Topic; D017277:Drug Approval; D015507:Drugs, Investigational / Q000009:adverse effects / Q000627:therapeutic use; D000069465:Febuxostat; D006073:Gout / Q000188:drug therapy* / Q000276:immunology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D053583:Interleukin-1beta / Q000037:antagonists & inhibitors; D027361:Organic Anion Transporters / Q000037:antagonists & inhibitors; D011092:Polyethylene Glycols / Q000009:adverse effects / Q000627:therapeutic use; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D013844:Thiazoles / Q000009:adverse effects / Q000627:therapeutic use; D014503:Urate Oxidase / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D015507:Drugs, Investigational; D006074:Gout Suppressants; D053583:Interleukin-1beta; D027361:Organic Anion Transporters; D011994:Recombinant Proteins; D013844:Thiazoles; C103862:urate transporter; D000069465:Febuxostat; D011092:Polyethylene Glycols; D000493:Allopurinol; D014503:Urate Oxidase; C031545:Pegloticase