Prophylaxis of Attacks of Acute Gouty Arthritis
Key Points • Gout attacks (also called “flares”) are commonly precipitated by factors that induce rapid rise (e.g., diet and alcohol excess, intensive diuresis for congestive heart failure) or decline…
Uricase Therapy of Gout
Key Points • Uricolytic therapy with uricase (urate oxidase) degrades uric acid, ultimately resulting in the production of allantoin, which is much more soluble and readily excreted in the urine…
Overview of Gout Therapy Strategy and Targets, and the Management of Refractory Disease
Key Points • Comprehensive management of gout involves identifying and addressing comorbid cause(s) of the hyperuricemia, treating and preventing attacks of gouty inflammation, and lowering serum urate to an appropriate…
Xanthine Oxidase Inhibitor Treatment of Hyperuricemia
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….
Quality of Care in Gout
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…
Diet, Alcohol, Obesity, Hyperuricemia, and Risk of Gout
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…
Uricosuric Therapy of Hyperuricemia in Gout
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…
Clinical Features of Gout
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…
Gout: Epidemiology and Risk Factors
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…
Articular Pathology of Gout, Calcium Pyrophosphate Dihydrate and Basic Calcium Phosphate Crystal Deposition Arthropathies
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…
