The first line treatments for acute gouty arthritis are nonsteroidal anti-inflammatory drugs (NSAID), corticosteroids, and colchicine. However, these agents are ineffective or contraindicated in a proportion of patients. Interleukin (IL)-1 is a key mediator in the pathogenesis of acute gouty arthritis. Recently, three IL-1-targeted agents have been developed, including anakinra, the IL-1 receptor antagonist. The authors present two patients with a flare of refractory tophaceous gout who were treated with anakinra.
Anakinra, IL-1 receptor inhibitor, gout, tophus.