Gout--current diagnosis and treatment.

Abstract:

BACKGROUND:Because of the changing dietary habits of an aging population, hyperuricemia is frequently found in combination with other metabolic disorders. Longstanding elevation of the serum uric acid level can lead to the deposition of monosodium urate crystals, causing gout (arthritis, urate nephropathy, tophi). In Germany, the prevalence of gouty arthritis is estimated at 1.4%, higher than that of rheumatoid arthritis. There are no German guidelines to date for the treatment of gout. Its current treatment is based largely on expert opinion. METHODS:Selective literature review on the diagnosis and treatment of gout. RESULTS AND CONCLUSIONS:Asymptomatic hyperuricemia is generally not an indication for pharmacological intervention to lower the uric acid level. When gout is clinically manifest, however, acute treatment of gouty arthritis should be followed by determination of the cause of hyperuricemia, and long-term treatment to lower the uric acid level is usually necessary. The goal of treatment is to diminish the body's stores of uric acid crystal deposits (the intrinsic uric acid pool) and thereby to prevent the inflammatory processes that they cause, which lead to structural alterations. In the long term, serum uric acid levels should be kept below 360 micromol/L (6 mg/dL). The available medications for this purpose are allopurinol and various uricosuric agents, e.g., benzbromarone. There is good evidence to support the treatment of gouty attacks by the timely, short-term use of non-steroidal anti-inflammatory drugs (NSAID), colchicine, and glucocorticosteroids.

journal_name

Dtsch Arztebl Int

authors

Tausche AK,Jansen TL,Schröder HE,Bornstein SR,Aringer M,Müller-Ladner U

doi

10.3238/arztebl.2009.0549

subject

Has Abstract

pub_date

2009-08-01 00:00:00

pages

549-55

issue

34-35

issn

1866-0452

journal_volume

106

pub_type

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