Key Points • Xanthine oxidase is a critical enzyme in the metabolism of purines to uric acid. Both allopurinol and febuxostat reduce serum urate concentration through inhibition of xanthine oxidase….
Key Points • Surprisingly, instances of suboptimal treatment of gout remain frequent, even in this era of expanded and well-understood treatment options. These include errors in medication use and dosages…
Key Points • Lifestyle and dietary modifications can influence serum urate levels and the risk of gout and are the only acceptable options when urate-lowering medications are not yet indicated…
Key Points • Inefficient renal excretion of uric acid is the most common cause of hyperuricemia in gout patients. • Uricosuric drugs tend to normalize renal excretion of uric acid…
Key Points • The key clinical features of acute gouty arthritis have been recognized for hundreds of years and include podagra (inflammatory arthritis of the first metatarsophalangeal joint), rapid rise…
Key Points • Unlike osteoarthritis and rheumatoid arthritis, gout is typically an episodic arthritis. The intervals between attacks can be as long as decades with complete absence of symptoms between…
Key Points • Each crystal type associated with arthritis forms in specific joint tissues dependent on the distinct metabolic environment. • Crystals require additional factors beyond tissue deposition to incite…
Key Points • Approximately 90% of cases of hyperuricemia are caused by uric acid underexcretion from the kidneys. In addition, renal hypouricemia is caused by increased renal uric acid excretion….
Key Points • Purine nucleotide synthesis and degradation form a crucial metabolic pathway for cell integrity and reproduction. • Phosphoribosyl pyrophosphate synthetase superactivity, a rare X chromosome–linked disorder, causes juvenile…
Key Points • Serum urate levels are highly heritable and principally determined by the fractional excretion of uric acid in the kidney. The heritability of gout remains to be properly…
