Latest evidence on gout management: what the clinician needs to know
- 25 October 2012
- journal article
- Published by SAGE Publications in Therapeutic Advances in Chronic Disease
- Vol. 3 (6), 271-286
- https://doi.org/10.1177/2040622312462056
Abstract
Until recently, the last drug approved for the treatment of gout by the United States Food and Drug Administration was allopurinol in 1966. Since 2008, two new drugs for the treatment of gout, febuxostat and pegloticase, have been approved in the US. Febuxostat has been approved in the EU and pegloticase approval is anticipated. A new single-ingredient colchicine preparation is available in the US, and the treatment recommendations for the use of colchicine in acute gout have evolved, now favoring a low-dose regimen. Several other exciting drugs are in development. Herein, we review some of basic principles in the diagnosis and staging of gout. We then examine current treatment principles, with particular attention to febuxostat and pegloticase, offering suggestions as to where they might fit into a modern therapeutic algorithm for gout treatment. We then present available data on several exciting new agents in development, including interleukin-1 inhibitors, and relate them to advances in our understanding of gout pathogenesis. We conclude with some important nonpharmacologic principles for optimal management of this ancient and eminently treatable disease. Dedicated gout research, going on quietly in the background of other breathtaking advances in rheumatology, is now paying off. This comes at a time when the number of patients affected by gout continues to rise, mainly due to an epidemic of obesity. An effort to improve lifestyle choices as a society and better management of the disease by clinicians should have a positive impact on gout incidence and outcome in our lifetimes.This publication has 76 references indexed in Scilit:
- The Epidemiology of Uric Acid and FructoseSeminars in Nephrology, 2011
- Inflammatory Gout: Observations over a Half‐CenturyThe FASEB Journal, 2011
- Canakinumab reduces the risk of acute gouty arthritis flares during initiation of allopurinol treatment: results of a double-blind, randomised studyAnnals Of The Rheumatic Diseases, 2011
- Hyperuricemia and coronary heart disease: A systematic review and meta‐analysisArthritis Care & Research, 2010
- The interleukin 1 inhibitor rilonacept in treatment of chronic gouty arthritis: results of a placebo-controlled, monosequence crossover, non-randomised, single-blind pilot studyAnnals Of The Rheumatic Diseases, 2009
- Plasma Urate Level Is Directly Regulated by a Voltage-driven Urate Efflux Transporter URATv1 (SLC2A9) in HumansOnline Journal of Public Health Informatics, 2008
- High-resolution ultrasonography of the first metatarsal phalangeal joint in gout: a controlled studyAnnals Of The Rheumatic Diseases, 2007
- EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee For International Clinical Studies Including Therapeutics (ESCISIT)Annals Of The Rheumatic Diseases, 2006
- EULAR evidence based recommendations for gout. Part I: Diagnosis. Report of a task force of the standing committee for international clinical studies including therapeutics (ESCISIT)Annals Of The Rheumatic Diseases, 2006
- Preliminary criteria for the classification of the acute arthritis of primary goutArthritis & Rheumatism, 1977