Gout and Its Comorbidities

Implications for Therapy

Lisa K. Stamp; Peter T. Chapman

Disclosures

Rheumatology. 2013;52(1):34-44. 

In This Article

Abstract and Introduction

Abstract

Gout is a common form of arthritis. It is associated with a number of comorbidities, including hypertension, cardiovascular disease, renal impairment, diabetes, obesity, hyperlipidaemia and frequently in a combination known as the metabolic syndrome. These comorbidities and their treatment may have an effect on the development of gout and on the choice of therapeutic agent. Treatment of acute gout with short-term corticosteroids may be a safer option than either NSAIDs or colchicine in patients with significant renal and/or cardiac impairment. Sustained reduction of serum urate <0.36 mmol/l is required for long-term management of gout. The optimal dosing regimen for patients with renal impairment is the subject of on-going investigation. There is less experience with newer urate-lowering therapies. This review will consider the relationship between comorbidities and gout with a particular focus on the treatment of gout and the potential interactions between drugs used for gout and those for comorbid conditions.

Introduction

Patients with gout frequently have multiple comorbidities, including hypertension, cardiovascular disease (CVD), renal impairment, diabetes, obesity, hyperlipidaemia and in combination known as the metabolic syndrome. These comorbidities and their treatment may have an effect on the development of gout and on the choice of therapeutic agent. Likewise, hyperuricaemia and gout may have an important role in the pathogenesis of the comorbidity. This review discusses the relationships between these comorbidities and gout and the therapeutic options for patients with gout and comorbidities.

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