Emerging therapeutic options for refractory gout

For individuals with gout, the treatment options beyond conventional urate-lowering therapies are expanding. Notable advancements in 2023 include developments in uricase therapy, new xanthine oxidase inhibitors, and a class of medications that offer dual benefits for the control of type 2 diabetes mellitus and gout. Co-administration of methotrexate or rapamycin-containing nanoparticles enhances the long-term effectiveness of uricase therapy by suppressing the production of anti-drug antibodies3,5.Tigulixostat, a xanthine oxidase inhibitor, has demonstrated high urate-lowering efficacy and a good safety profile compared with placebo, but head-to-head comparison to allopurinol is still required6.Sodium-glucose cotransporter-2 (SGLT2) inhibitors provide dual benefits as they not only serve as antidiabetic therapies but also reduce serum urate concentrations and the risk of gout flare8,9.