Updates in the Management of Gout

• Published in: The American journal of medicine Vol. 120; no. 3; pp. 221 - 224
• Main Authors: Keith, Michael P., MD, Gilliland, William R., MD, MHPE
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-03-2007; Elsevier; Elsevier Sequoia S.A
• Subjects: Acute Disease; Adrenal Cortex Hormones - therapeutic use; Adult; Aged; Allopurinol - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Arthritis, Gouty - diagnosis; Arthritis, Gouty - drug therapy; Biological and medical sciences; Chronic Disease; Colchicine; Colchicine - therapeutic use; Disease management; Drug therapy; Drug Therapy, Combination; Family Practice - standards; Family Practice - trends; Febuxostat; Female; General aspects; Gout; Gout - diagnosis; Gout - drug therapy; Gout Suppressants - therapeutic use; Humans; Inflammatory diseases; Internal Medicine; Male; Management; Medical sciences; Medical treatment; Metabolic diseases; Middle Aged; Miscellaneous; Nonsteroidal anti-inflammatory agents; Other metabolic disorders; Pain management; Pain Measurement; Primary care; Probenecid; Prognosis; Rheumatism; Risk Assessment; Severity of Illness Index; Treatment Outcome; Uric Acid - urine; Xanthine oxidase; Nonsteroidal anti-inflammatory agents; Febuxostat; Gout; Xanthine oxidase; Management; Colchicine; Probenecid; Medicine; Clinical management; Treatment; Microcristalline arthropathy; Diseases of the osteoarticular system
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/j.amjmed.2006.02.044

Abstract The majority of patients with gout are cared for by primary care physicians. Although both the physician and patient may easily recognize the acute arthritis of gout, errors in selecting the most appropriate medication and proper dose are common. The clinical stages of gout include asymptomatic hyperuricemia, intermittent gouty arthritis, and chronic tophaceous gout. Treatment of gout is usually considered after the first attack of arthritis, typically podagra. The aims of treatment are to alleviate the pain and inflammation associated with acute attacks, prevent future attacks, and decrease uric acid levels. Confusion frequently arises because certain medications such as colchicine may have dual purposes: to treat an acute attack and to suppress future attacks. The purpose of this management update is to provide practical advice about prescribing the proper medication considering both treatment goals and patient comorbidities.