Description

Canakinumab is a human monoclonal antibody that selectively neutralizes interleukin-1β (IL-1β), a key mediator of inflammation in gout. It is used for the treatment of difficult-to-treat gout in patients with frequent flares and contraindications to standard therapies. The β-RELIEVED and β-RELIEVED-II trials (Schlesinger et al., 2012) demonstrated that canakinumab provided rapid and sustained pain relief in acute gout attacks and significantly reduced the risk of new flares compared to triamcinolone acetonide. A subsequent study by Schlesinger et al. (2014) showed that canakinumab was effective in preventing flares during initiation of allopurinol therapy. However, canakinumab is associated with an increased risk of serious infections due to its immunosuppressive effects. A long-term safety study by Kivitz et al. (2018) confirmed this increased infection risk but found no new safety signals with extended use. Given its high cost and potential for serious adverse events, canakinumab is typically reserved for patients with severe, refractory gout who have failed or cannot tolerate other treatment options.