Treating the Effects of Gout Treatment

Rilonacept reduces gout flare ups

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) The side effects of certain drugs can make some gout patients quit treatment. Fortunately, there may be one drug that stops the painful flare-ups sometimes associated with gout treatment.

Rilonacept (sold as Arcalyst to treat a different disease) appears to reduce acute gout flare-ups (episodes of pain and inflammation) that happen when starting treatment to lower levels of uric acid.

"Talk to your doctor to find the gout treatment that works for you."

Gout is a type of arthritis that develops when uric acid builds up in the blood, causing joint inflammation and pain. While gout attacks usually resolve on their own in a few days, urate crystals can be left behind in a joint, which can lead to repeated attacks. For this reason, a key part of gout treatment is drug therapy to lower uric acid levels.

In some patients, urate-lowering therapy can lead to additional gout flare-ups as urate crystals are released and interact with cells that produce a protein called interleukin-1, which can cause inflammation and pain. In other words, the treatment used to get rid of the crystals that cause inflammation can also lead to inflammation, especially in the early months of treatment. This can lead some patients to stop therapy.

Rilonacept is made to stop interleukin-1 before it can send signals that trigger inflammation. As such, H. Ralph Schumacher, M.D., of the Perelman School of Medicine at the University of Pennsylvania, and colleagues wanted to see if rilonacept was effective in preventing gout flare-ups associated with urate-lowering therapy.

They found that patients who took rilonacept had significantly fewer gout flare-ups than those who took a placebo. There were only six flare-ups in the rilonacept group, whereas the placebo group experienced 33 flare-ups. This reduction in flare-ups was seen as early as four weeks after patients started treatment.

There were no deaths or serious infections among patients taking rilonacept. The most common side effects of rilonacept were less serious infections followed by musculoskeletal disorders. However, these  were reported in only about 15 percent of the rilonacept patients.

"Rilonacept appears safe and well tolerated and could increase patient adherence to long-term urate-lowering therapy," Dr. Schumacher conlcudes. The study's authors say that more research on rilonacept for gout patients is needed.

Eighty-three gout patients were involved in this phase II clinical trial. Of these patients, 41 were assigned to take rilonacept injections while the other 42 patients were assigned to take a weekly placebo. All of the participants had started treatment with allopurinol (sold as Lopurin and Zyloprim) to lower uric acid levels.

The results are published in the journal Arthritis & Rheumatism

Reviewed by: 
Review Date: 
January 16, 2012
Last Updated:
January 20, 2012