On valentine’s day this year, the FDA gave all of us gout sufferer’s a special valentine’s day gift. They approved the first new gout drug in more than forty years. But the good news doesn’t end there. There are several other new gout drugs that are in development.

Febuxostat

Febuxostat is the generic name for the drug released on Valentine’s day.  It will be sold on the market under the brand name Ulroic® and is the first new xanthine oxidase inhibitor to be approved since allopurinol.  Xanthine oxidase inhibitors are medications that block the xanthine oxidase enzyme from creating uric acid in the body and thus, lowers uric acid levels.  This medication is chemically very different from allopurinol so it is hoped that people that have had allergic reactions to allopurinol will be able to take Uloric without any problems.  Though there are many documented cases of people that where allergic to allopurinol that have taken febuxostat without any problems, I would still recommend caution if you have had severe reactions to allopurinol — better safe than sorry.  Its best to start this medication at a very low dose and watch for any adverse reactions.

Also, about 5% of people who took 120mg of this medication per day showed abnormalities in liver function blood tests.  However, this is only slightly higher than those taking allopurinol (4%).  So if you do take this medication, it wouldn’t be a bad idea to ask your doctor to monitor your liver function a bit more closely by increasing the frequency of liver function tests.  Other side effects are pretty uncommon but included: upper respiratory tract infections, musculoskeletal, connective tissue or joint signs and symptoms, headache and diarrhea.

Puricase®

Puricase is an interesting new drug that is still in late stage trials but has been approved as a “orphaned” drug which will help it get though the approval process more quickly.  Orphaned drug status is given to a drug that are developed specifically to treat a rare medical condition.  In this case, gout that has failed to respond to any other treatment method.  This will give new hope to those that have failing livers and/or kidneys or have particularly stubborn cases of gout.

Puricase reduces uric acid levels in a very novel way.  Every mammal on earth, except for some apes and man have an enzyme called uricase which breaks down uric acid in to simpler substances that are easily removed from the body.  You cannot simply take uricase and inject it into a human because the immune system recognizes it as a foreign body and attacks it, causing an allergic reaction and breaks the enzyme down before it can do any good.  Puricase, uses the uricase enzyme but locks it in a tiny molecular cage which protects it from the immune system but the bars of the cage are just big enough to let uric acid in where it can then be broken down.  Amazing technology.

Unfortunately however, this medication can only be injected but luckily only needs to be given once a month.  The most common side effects are similar to a mild allergic reaction.  When building “cages” that small, I would imagine that some are not prefect.  Regardless, these symptom are very likely better than gout attacks, particularly for the people that this drug is intended to treat.

Rilonacept

This is a anti-inflammatory drug targeted for use as a prophylaxis when starting uric acid lowering therapy.  When starting uric acid lowering medications, uric acid levels in the body will start to fluctuate wildly as uric acid starts to seep out from every corner of your body where it is then removed by the kidneys and intestines.  This fluctuation is what can trigger gout attacks.  Eventually, over the period of months, uric acid levels will stabilize, the risk of gout attacks will diminish and this prophylaxis treatment can be stopped.

Rilonacept, which will be sold under the trade name Arcalyst® is targeted to be a prophylaxis medication.  Currently, colchicine is the most commonly used medication for this purpose but this medication can cause some pretty unpleasant side effects including nausea, vomiting and diarrhea.  No word yet on what the side effects of this medication are or when it will be released.

Other medications

There are other medications that are in the pipeline including a new uricosuric, medication that helps your kidneys filter out uric acid like probenecid, but these medication are still in early drug trials and are years away from hitting the market. So I won’t get your hope up just yet.

The best news is that people are starting to pay attention to this long forgotten disease again.  The interest by the drug companies is resulting in a lot of new funding for research into this disease which will benefit all of us even if we never take any of these medications.  It is also getting scientists interested in this disease by showing that there are still a lot of unanswered questions about gout.  All good news…

If you liked this post, you will love the book, Beating Gout: A Sufferer’s Guide to Living Pain Free. Get the whole story in one easy-to-understand book, get your copy of Beating Gout: A Sufferer’s Guide to Living Pain Free now. Over 500 research articles and texts where studied and dozens of world class experts on gout were interviews for this book yet it is written for the non-expert. No other book on gout is more up-to-date, comprehensive or easy-to-understand – guaranteed!