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Gout in 2023

Emerging therapeutic options for refractory gout

Nature Reviews Rheumatology volume 20, pages 73–74 (2024)Cite this article

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For individuals with gout, the treatment options beyond conventional urate-lowering therapies are expanding. Notable advancements in 2023 include developments in uricase therapy, new xanthine oxidase inhibitors, and a class of medications that offer dual benefits for the control of type 2 diabetes mellitus and gout.

Key advances

  • Co-administration of methotrexate or rapamycin-containing nanoparticles enhances the long-term effectiveness of uricase therapy by suppressing the production of anti-drug antibodies3,5.

  • Tigulixostat, a xanthine oxidase inhibitor, has demonstrated high urate-lowering efficacy and a good safety profile compared with placebo, but head-to-head comparison to allopurinol is still required6.

  • Sodium-glucose cotransporter-2 (SGLT2) inhibitors provide dual benefits as they not only serve as antidiabetic therapies but also reduce serum urate concentrations and the risk of gout flare8,9.

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References

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Author information

Authors and Affiliations

  1. Division of Rheumatology, Department of Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

    Kanon Jatuworapruk

  2. Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand

    Worawit Louthrenoo

Authors
  1. Kanon Jatuworapruk
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  2. Worawit Louthrenoo
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Correspondence to Worawit Louthrenoo.

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Competing interests

K.J. is a co-investigator in the EURELIA2 study (NCT05586971), sponsored by LG Chem. W.L. declares no competing interests.

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Jatuworapruk, K., Louthrenoo, W. Emerging therapeutic options for refractory gout. Nat Rev Rheumatol 20, 73–74 (2024). https://doi.org/10.1038/s41584-023-01066-5

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