GOUT IN 2018

Prevention and treatment of gout

In 2018, advances in the treatment of gout flares came in the form of a new nurse-led management approach to serum urate lowering and evidence that allopurinol might have a better cardiovascular safety profile than febuxostat. However, are IL-1β blockers such as canakinumab the future of care for patients with gout?

Key advances

  • Nurse-led care can improve outcomes for people with gout and is cost effective2.

  • Febuxostat should be used with caution in people with gout and established cardiovascular disease3.

  • The IL-1β inhibitor canakinumab prevents incident gout without altering serum urate levels4.

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Correspondence to Lisa K Stamp.

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Competing interests

L. S. declares that she has received speaker fees from Amgen and is currently a co-investigator on a clinical trial (ACTRN12615001219572) of intensive urate-lowering therapy (funded by the Health Research Council of New Zealand). N.D. declares that she has received speaking fees from AbbVie, Horizon, Janssen and Pfizer, consulting fees from Hengrui, Horizon and Kowa, research funding from Amgen and AstraZeneca and is currently principal investigator on a clinical trial (ACTRN12615001219572) of intensive urate-lowering therapy (funded by the Health Research Council of New Zealand). N.D. also declares that within the past 5 years she has been principal investigator on a clinical trial of febuxostat (NCT01078389) in early gout and has received consulting or speaking fees from Menarini, Takeda and Teijin.

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Stamp, L.K., Dalbeth, N. Prevention and treatment of gout. Nat Rev Rheumatol 15, 68–70 (2019). https://doi.org/10.1038/s41584-018-0149-7

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