For those suffering from gout, an inflammatory arthritis caused by excess uric acid, there is promising news on the medication front. Pharmaceutical research continues to develop improved treatment options to better manage this common and often debilitating condition.
New Uric Acid-Lowering Drugs
Several new xanthine oxidase inhibitors have been approved giving doctors more tools to lower high serum uric acid levels, a key trigger for painful gout flares. Febuxostat (Uloric) stands out as a novel non-purine alternative to traditional allopurinol that is less limited by interactions and intolerance. The investigational drug verinurad increases uric acid excretion and has shown promise combined with febuxostat.
Novel Uricosurics
Uricosuric agents promote elimination of uric acid via the kidneys. Lesinurad (Zurampic) enhances excretion in combo with xanthine oxidase inhibitors. New sodium-glucose transporter (SGLT2) inhibitors like canagliflozin used for type 2 diabetes also have uricosuric effects beneficial for gout. Dual SGLT2/SGLT1 inhibitors are in development to further boost uric acid removal.
Improved Anti-Inflammatory Approaches
Inflammation during acute gout flares responds well to corticosteroids, but there are concerns over long-term exposure. Recent research shows promise for alternative anti-inflammatory drugs like anakinra, rilonacept, and canakinumab that neutralize interleukin-1, a pivotal mediator of gouty inflammation. Colchicine dosing strategies have also been refined.
Novel Drug Delivery Systems
Novel formulations are being tested to optimize delivery of gout medications. Options include injectable biodegradable microspheres releasing pegloticase over months and lipid nanoparticle-encapsulated colchicine for oral intake and targeted distribution. Such innovations may allow enhanced efficacy with reduced side effects.
Gout Treatment Guidelines
Expert treatment guidelines continue to evolve, with the latest recommendations published in 2020. These provide updated, evidence-based protocols for properly diagnosing gout and using urate-lowering therapies, anti-inflammatory medications, and prophylaxis to optimize outcomes.
With greater choice of medications and improved approaches, the future looks brighter for effectively managing gout’s burdensome symptoms while lowering associated cardiovascular risks. Continuous research and drug development efforts will further expand and refine pharmaceutical options for tackling this complex form of arthritis.
