Confirmation that the IL-1 inhibitor rilonacept reduces gout flare occurrence during the initiation of urate-lowering therapy (ULT) has come from a phase III trial in a multi-ethnic cohort. Adults with hyperuricaemia, gout and ≥2 flares within the past year (n = 248; 53.2% white, 33.1% Asian, 13.7% black) began ULT with allopurinol alongside a weekly subcutaneous dose of placebo, 80 mg rilonacept or 160 mg rilonacept for 16 weeks. During this time, 43.9% of patients in the placebo group had no flares compared with 71.3% and 72.6% in the rilonacept groups (P ≤0.0001); also, significantly fewer patients had multiple flares with rilonacept than placebo.