Anakinra, a recombinant IL-1β receptor antagonist, was proved to be an effective treatment alternative for the acute gout flares as explained in the results of a randomized, double-blind, placebo-controlled, active comparator, non-inferiority (NI) trial study published in 'Rheumatology'. 

The present study was conducted by Carly A Janssen et al. to find out whether anakinra is effective and safe for the treatment of patients with acute gout flares. Patients suffering from a cystal-proven acute gout flare were selected. Selected patients were randomized (1:1) to receive treatment as usual (colchicine/prednisone/naproxen) or treatment with anakinra. Change in pain between baseline and averaged pain score on days 2 to 4 as measured on a five-point rating scale was considered as the primary endpoint. In the analysis of covariance model, the NI of anakinra would be exhibited in the upper bound of the 95% CI of the numeric difference in changed pain scores between treatment groups did not exceed the NI limit of 0.4 in favour of treatment as usual, in the per-protocol (PP) and intention-to-treat (ITT) populations. The secondary outcomes comprised of safety assessments, swelling, tenderness, improvement in pain and treatment response after 5 days, calculated via the linear mixed models and binary logistic regression models. Eighty-eight subjects were incorporated (Patients receiving anakinra= 43; patients receiving as usual treatment= 45). In both (PP and ITT) populations, anakinra was not found to be superior to as usual treatment. In either of the treatment arm, no unexpected or uncommon (serious) adverse events were noticed. The analyses of secondary outcomes suggested a considerable decrease in gout symptoms as described by the patients of both the groups.  The investigators found anakinra to be a useful alternative for treating acute gout flares.