Update on Gout and Hyperuricemia

J. F. Baker; H. Ralph Schumacher

Disclosures

Int J Clin Pract. 2010;64(3):371-377. 

In This Article

Abstract and Introduction

Abstract

There have been recent advances in the understanding of underlying mechanisms and treatment of gout and chronic hyperuricemia, making this an important time to review the current state of the disease. The goal of this article is to provide a practical review of the current standard of care as well as discuss some new developments in the management. There is an increasing prevalence of gout and hyperuricemia worldwide. Gout confers a significant individual and societal burden and is often under-treated. Appropriate diagnosis and treatment of acute gout should be followed by aggressive and goal-oriented treatment of hyperuricemia and other risk factors. Allopurinol remains as a first-line treatment for chronic hyperuricemia, but uricosuric agents may also be considered in some patients. Febuxostat, a non-purine xanthine-oxidase inhibitor, is a new agent approved for the treatment of hyperuricemia in patients with gout, which may be used when allopurinol is contraindicated. Gout and hyperuricemia appear to be independent risk factors for incident hypertension, renal disease and cardiovascular disease. Physicians should consider cardiovascular risk factors in patients with gout and treat them appropriately and aggressively.

Introduction

The recent approval of febuxostat, the first new agent for gout in 40 years for use in the treatment of chronic hyperuricemia associated with gout, lead the editors of the IJOP to request this review to address current guidelines for the diagnosis and management of gout, some new developments for consideration by the treating physician and the epidemiology of this increasing international health concern. The goal of this review is to provide the practicing physician with a practical overview of the state of gout worldwide with specific attention to management strategies, both current and novel.

Comments

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