Gout is the most common inflammatory
arthritis in humans. Current treatment options to control the
pain and
inflammation of acute and chronic
gout include nonsteroidal anti-inflammatory drugs,
colchicine, and
corticosteroids. However, patients are commonly unresponsive to, intolerant of, or have
contraindications to current treatments.
Interleukin-1 (IL-1), a proinflammatory
cytokine, plays a major role in mediating gouty
inflammation. This role of
IL-1 has led investigators to explore a new class of anti-inflammatory drugs that inhibit
IL-1 signal transduction.
IL-1 inhibitors currently in trials for
gout include
anakinra,
rilonacept, and
canakinumab.
Anakinra is an IL‑1 receptor antagonist that inhibits the activity of both IL‑1α and IL‑1β,
rilonacept is a soluble decoy receptor and
canakinumab is an anti‑IL‑1β
monoclonal antibody. In case cohorts,
anakinra was found to be efficacious in combating acute
gout pain and
inflammation, whereas
rilonacept has been found to be efficacious for reducing the risk of recurrent attacks.
Canakinumab has been shown to be efficacious in both reducing
pain and
inflammation in acute attacks, and for reducing the risk of recurrent attacks. All three
IL-1 inhibitors are generally well tolerated. This article reviews the current
IL-1 inhibitors and the results of trials in which they have been tested for the management of acute and chronic gouty
inflammation.