Studies were excluded if they were published in a non-English language, examined diseases other than gout, evaluated the treatment of acute GFs or their prophylaxis without initiating ULT or were a We retrieved 44 articles for review, of which 17 did not specifically investigate gout. We then searched for all trials that examined the efficacy of prophylactic drugs during initiation of ULT by using the following search terms: gout, prophylaxis, prevention and randomized controlled trials (RCTs). Gout is an inflammatory arthritis caused by deposition in the joints of monosodium urate (MSU) crystals that result from chronic hyperuricaemia. Under certain conditions, such as with a rapid decrease of urate levels induced by ULT, the presence of free fatty acids after food intake or alcohol consumption [ Colchicine is one of the most frequently used drugs for treating acute gout. The following search terms were used to retrieve key papers: gout, flares, arthritis, prophylaxis, prevention, uric acid–lowering therapy, urate-lowering therapy, allopurinol, febuxostat, pegloticase, benzbromarone, probenecid, colchicine, NSAIDs, corticosteroids, canakinumab, anakinra, rilonacept and IL-1 blockers. Of note, the US Food and Drug Administration has not approved canakinumab for either prophylaxis or the treatment of flares, mainly because of safety concerns. Risk factors for gout include: 1. Thank you for submitting a comment on this article. The guideline, Management of Acute and Recurrent Gout, ... should be held with patients who have recurrent gout attacks before initiating urate-lowering therapy and concomitant prophylaxis. Although no IL-1 blockers are approved as prophylactic treatment, this class of drug could become an interesting option for patients with gout with intolerance or contraindication to colchicine, NSAIDs or corticosteroids. up to 6 months), according to the individual risk of flares assessment. Search for other works by this author on: Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritisA pilot study of IL-1 inhibition by anakinra in acute goutCanakinumab for acute gouty arthritis in patients with limited treatment options: results from two randomised, multicentre, active-controlled, double-blind trials and their initial extensionsRilonacept in the treatment of acute gouty arthritis: a randomized, controlled clinical trial using indomethacin as the active comparatorRilonacept (interleukin-1 trap) for prevention of gout flares during initiation of uric acid-lowering therapy: results from a phase III randomized, double-blind, placebo-controlled, confirmatory efficacy studyHyperuricaemia and gout: state of the art and future perspectivesEfficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trialsFebuxostat compared with allopurinol in patients with hyperuricemia and goutAdherence with urate-lowering therapies for the treatment of goutNew ACR guidelines for gout management hold some surprisesInitiation of allopurinol at first medical contact for acute attacks of gout: a randomized clinical trialPatients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational studyEffects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trialThe urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trialProphylactic colchicine therapy of intercritical gout. Studies were eligible for inclusion if they were original articles of a randomized controlled design that included adults with gout and evaluated the prophylaxis of GFs following initiation of ULT.
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