New Treatments & Drugs for Gout Flare-ups

Quick Take

By early 2010, current research in treating gout flare-ups was under way in clinical trials in a number of centers. If you are suffering from severe exacerbations of gout, talking to your doctor about some of these investigatory drugs or perhaps enrolling in one of the trials may prove beneficial.

On this page

Completed Studies with Results

Here are two drugs studied in clinical trials on current research in treating gout flare-ups with published results. The sponsor is listed after the drug name, followed by the Clinical Trials database identifier. Publications are listed in the References section.

Febuxostat and Allopurinol

Febuxostat was more effective in lowering urate levels than allopurinol in one test. In another study, either drug nearly eliminated gout flares. However, in another report febuxostat, while effective in stopping the flare-ups, seemed to result in more frequent episodes [1]. Takeda Global Research & Development Center, Inc. NCT00430248

Canakinumab. Novartis Pharmaceuticals. 862-778-8300. NCT00927810 (completed but no published results)

MPC-4 (Colchicine). Some positive results with most prevalent adverse effect being diarrhea.

Studies Recruiting Volunteers

These clinical studies are recruiting volunteers, some of which have multiple study locations. They are listed with the name of the drug, the sponsor, contact information and the Clinical Trials identifier (search https://www.clinicaltrials.gov/ with this identifier for more information). Please note: Studies may close recruitment. Always verify using the clinicaltrials database.

Rilonacept. Regenereon Pharmaceuticals. Brian Ford. 919-240-5259. NCT00855920
Oral BCX4208. BioCryst Pharmaceuticals. William P. Sheridan, MB BS NCT 00985127
Apremilast. Dartmouth-Hitchcock Medical Center. Robert Wortmann, MD NCT00997581
Uricase-PEG 20. EnzymeRX. Rocelle Flores, 201-843-4424, ext. 203. NCT01038947
MBX-102 and Allopurinol. Brian Roberts, MD. 510-293-8800. NCT1399008

Publications from Clinical Studies

A 2009 German study claimed that pharmacological intervention should only enter the picture if gout is clinically manifest, i.e., not if hyperuricemia, which causes gout, is asymptomatic. If it was clinically significant, this review recommended allopurinol or benzbromarone. Otherwise, the article suggested treating gouty attacks with short-term use of non-steroidal anti-inflammatory drugs, colchicines or glucocorticosteroids. [2]

A review article from the Roger Williams Medical Center, Rhode Island agrees with other current research in treating gout flare-ups by claiming that trying to manage hyperuricemia should only be attempted once the symptoms of an acute gout attack have been brought under control with high-dose half-life NSAIDs. If the patient cannot tolerate NSAIDs because of other comorbidities, then systemic corticosteroids may be used. [3]

In 2006, the medical journal Current Rheumatology Reports published an article discussing the uricosuric (uric acid-lowering) effects of drugs that are normally prescribed for other conditions. These included losartan, atorvastatin, and fenofibrate. [4]

Drug Side Effects

Almost all pharmaceutical products can have side effects, which vary in severity and importance. Gout drugs are no different. Here are some reported side effects from traditional and newer treatments:

NSAIDs. Upset stomach, bleeding, kidney damage
Colchicine. Peripheral neuritis, muscular weakness, nausea, vomiting. Generic versions may not be bioidentical to the trade-name version. [5]
Probenecid. Headache, dizziness, vomiting, nausea, anorexia
Corticosteroids. Sodium retention, joint damage with overuse, inflammation
Allopurinol. Upset stomach, skin rash, white blood cell increase, liver or kidney damage
Febuxostat. Liver function abnormalities, nausea, arthralgias, rash
Canakinumab. Nasopharyngitis, diarrhea, influenza, rhinitis, nausea
Rilonacept. Injection-site reaction, upper respiratory tract infection, nausea, diarrhea, sinusitis
Oral BCX4208. Not yet reported.
Apremilast. Not yet reported. Clinical study not yet recruiting
Uricase-PEG 20. Not yet reported. Study began December 2009