Emerging therapies for gout.
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.
Department of Medicine, University of Florida College of Medicine, 1600 South West Archer Road, Gainesville, FL 32610-0277, USA. Electronic address: edwarnl@medicine.ufl.edu.
N Lawrence
NL
Edwards
Service de Rhumatologie, CHUV, Avenue Pierre Decker, Lausanne 1011, Switzerland.
Alexander
A
So
D000081:Acetamides / Q000627:therapeutic use; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001569:Benzodiazepines / Q000627:therapeutic use; D000069465:Febuxostat; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D050113:Imino Furanoses / Q000627:therapeutic use; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use; D053583:Interleukin-1beta / Q000037:antagonists & inhibitors*; D053486:Melanocortins / Q000627:therapeutic use*; D010648:Phenylacetates / Q000627:therapeutic use; D011092:Polyethylene Glycols; D011744:Pyrimidinones / Q000627:therapeutic use; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use; D013844:Thiazoles; D013864:Thioglycolates / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D014503:Urate Oxidase; D014528:Uricosuric Agents / Q000627:therapeutic use*
D000081:Acetamides; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D006074:Gout Suppressants; D050113:Imino Furanoses; D053590:Interleukin 1 Receptor Antagonist Protein; D053583:Interleukin-1beta; D053486:Melanocortins; D010648:Phenylacetates; D011744:Pyrimidinones; D011993:Recombinant Fusion Proteins; D013844:Thiazoles; D013864:Thioglycolates; D014230:Triazoles; D014528:Uricosuric Agents; C000593471:lesinurad; D000069465:Febuxostat; D001569:Benzodiazepines; C000593473:arhalofenate; C541220:canakinumab; D011092:Polyethylene Glycols; C531377:rilonacept; D000324:Adrenocorticotropic Hormone; D014503:Urate Oxidase; C000593472:ulodesine; C031545:Pegloticase; C012582:tofisopam
Febuxostat; Gout; Interleukin-1 inhibitor; Lesinurad; Melanocortin; Pegloticase; Ulodesine; Urate-lowering therapy