Anakinra is an interleukin-1 (IL-1) receptor antagonist used off-label for treating acute gout flares, especially in patients who cannot tolerate or do not respond to standard therapies like NSAIDs, colchicine, or corticosteroids. It works by blocking IL-1, a key cytokine involved in the intense inflammation seen in gout attacks. Anakinra is typically given as a short course of subcutaneous injections and can rapidly reduce pain and swelling.

While effective, it is generally reserved for refractory cases due to its high cost and potential side effects, including increased risk of infections. It is not used for long-term urate-lowering therapy.