title: Canakinumab for the Patient With Difficult-to-Treat Gouty Arthritis: Review of the Clinical Evidence.
abstract: Many patients with gouty arthritis experience frequent flares and have comorbidities that may limit their anti-inflammatory treatment options for acute flare management. For patients with contraindications to both NSAIDs and/or colchicine, treatment options are particularly limited, and there is an unmet medical need in this subgroup of patients. Two phase 3 studies and their extensions have demonstrated that a single dose of canakinumab during an acute flare provided rapid and effective pain relief and prolonged suppression of flares and inflammation in patients with a history of frequent flares and contraindicated for, intolerant of, or unresponsive to NSAIDs and/or colchicine. Canakinumab was consistently superior to the active comparator triamcinolone acetonide and was generally well tolerated in this patient population with a high prevalence of multiple medical comorbidities. Canakinumab should therefore be considered as a treatment option in a target population of patients with frequent gouty arthritis attacks who are unable to use NSAIDs and colchicine and in whom frequent use of corticosteroids is not considered appropriate.
authors.affiliation: Head, Department of Rheumatology, Lariboisière Hospital, Assistance Publique Hôpitaux de Paris, University Paris VII, Paris, France. Electronic address: thomas.bardin@lrb.aphp.fr.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bardin
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D015210:Arthritis, Gouty / Q000188:drug therapy* / Q000276:immunology; D003078:Colchicine / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D053583:Interleukin-1beta / Q000037:antagonists & inhibitors*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D005938:Glucocorticoids; D006074:Gout Suppressants; D053583:Interleukin-1beta; C541220:canakinumab; D003078:Colchicine
keywords: Anti-IL-1β therapy; Canakinumab; Gouty arthritis; Triamcinolone acetonide; β-RELIEVED; β-RELIEVED II