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Gout is the most common inflammatory arthritis in the United States (Figure), with a prevalence of about 3%, (1) and the number of persons with gout has increased over the [...], No new drug was FDA-approved for gout for close to 45 years, but new drugs are on the market now and others are in development. Established treatments often are effective, but each has limitations. In 2009, the FDA approved a nongeneric colchicine for acute gout. Investigators are exploring anti-interleukin-1β therapy. Anakinra has been studied off-label for acute gout. Rilonacept is being investigated for treatment and prophylaxis of gouty inflammation and canakinumab for acute gout attacks. Clinical trials of a novel urate transporter 1 inhibitor, RDEA594, are under way. Reducing the production of uric acid may be achieved with allopurinol. Febuxostat gained FDA approval in 2009 for managing hyperuricemia in patients with established gout. Rasburicase and pegloticase have been developed for uricase replacement. more...