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Pathophysiology, Clinical Presentation and Treatment of Gout

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Abstract

Gout is a common form of inflammatory arthritis that has been managed primarily in general medical practices for centuries. It appears that there has been an increasing prevalence of gout over the past decades, implying a growing public health burden. Accurate diagnosis and recognition of the various stages and manifestations of gout enable realistic goal setting for management. Recent evidence suggests new risk factors and potentially refutes others. Management of gout requires characterising and modifying risk factors and associated disorders, and commonly initiating drug therapy. Pharmacotherapy of gout includes the management of acute flares with anti-inflammatory agents such as NSAIDs and glucocorticoids and long-term treatment with urate-lowering drugs. Although pharmacotherapy is generally safe and effective, there are caveats and limitations to all gout therapies. Patient non-adherence and errors with the use of drugs for gout treatment are important factors leading to medical failures. With early intervention, careful monitoring and patient education, gout is a condition that can be managed very effectively. The advent of new drugs (such as febuxostat and urate oxidase [uricase]) and enhanced understanding of the pathogenesis of gout continue to improve our therapeutic options, particularly in a subset of patients with refractory disease and those who are intolerant to currently available medications.

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Acknowledgements

Assistance from the Agency for Healthcare Research and Quality (AHRQ) Centers for Education and Research on Therapeutics cooperative agreement (U18-HS10389) is acknowledged. Dr Saag has acted as a consultant and received honoraria and grants from TAP and affiliates.

Author information

Authors and Affiliations

  1. Department of Medicine, Division of Clinical Immunology and Rheumatology, Center for Education and Research on Therapeutics of Musculo-skeletal Disorders, University of Alabama at Birmingham, Birmingham, Alabama, 35294-3296, USA

    Gim Gee Teng, Raj Nair &  Kenneth G. Saag

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  1. Gim Gee Teng
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  2. Raj Nair
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  3. Kenneth G. Saag
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Correspondence to Kenneth G. Saag.

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Teng, G.G., Nair, R. & Saag, K.G. Pathophysiology, Clinical Presentation and Treatment of Gout. Drugs 66, 1547–1563 (2006). https://doi.org/10.2165/00003495-200666120-00002

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  • DOI: https://doi.org/10.2165/00003495-200666120-00002

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