Canakinumab in gout

Introduction: Gout is a painful inflammatory arthritis with a prevalence of approximately 4% in the United States, affecting an estimated 8.3 million adults. The past 20 years have shown significant increases in the number of patients with gout and its incidence may still be increasing. Current treatment options to control the pain and inflammation of acute gout include nonsteroidal anti-inflammatory drugs, colchicine and corticosteroids, although patients are often unresponsive to, intolerant of, or have contraindications for, these therapies. Additional treatment options are therefore needed for this population with difficult-to-treat gout. Areas covered: Currently available and investigational anti-inflammatory agents for acute and chronic gout will briefly be reviewed. Canakinumab, a fully human monoclonal anti-interleukin (IL)-1 beta antibody that selectively blocks IL-1 beta and that is being investigated for the treatment of gout, will be discussed in greater detail. Expert opinion: Canakinumab has been found to be superior to triamcinolone acetonide in acute gout and to colchicine in gout attack prophylaxis in reducing pain and risk of new gout attacks. Canakinumab's long half-life contributes to its prolonged anti-inflammatory effects.