Gout is a chronic autoinflammatory joint disease affecting an increasing proportion of the population. In treatment of flares we can use traditional anti-inflammatory drugs [nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine and glucocorticoids] and as a second-line biologic therapy with canakinumab which is a selective interleukin-1 beta (IL-1b) antagonist. This paper presents two clinical cases of patients treated with canakinumab due to lack of efficacy and contraindications to first-line drugs.