We can make gout management more successful now.
OBJECTIVE
The purpose of this editorial review is to identify and comment on factors contributing to the current less-than-optimal state of gout management and to emphasize immediate opportunities to improve management practices affecting many patients with gout.


RESULTS
Numerous publications document deficits in the current management and clinical outcomes of gout despite detailed understanding of the pathogenesis and pathophysiology of the disorder, the ability to establish the diagnosis with certainty, and the likely effectiveness, for most patients, of available lifestyle and pharmacological interventions. Among impediments to successful gout management are diagnostic inaccuracy; a paucity of validated management recommendations to guide care providers; incomplete patient education about gout and the aims and modalities of management; suboptimal patient adherence, even to demonstrably effective therapeutic recommendations; comorbidities and drug interferences that complicate treatment of gout; patient groups at special risk for progression to chronic tophaceous gout; and limited urate-lowering alternatives.


CONCLUSIONS
Recent publication of evidence-based recommendations for the diagnosis and management of gout and the impending availability of new urate-lowering agents suggest that this is an opportune time to initiate professional and patient education efforts toward improved management of this increasingly common disorder.
Becker
Michael A
MA
Rheumatology Section, Department of Medicine, University of Chicago Pritzker School of Medicine, 5841 South Maryland Avenue, Chicago, IL 60637, USA. mbecker@medicine.bsd.uchicago.edu
Chohan
Saima
S
D019317:Evidence-Based Medicine; D006073:Gout / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D040242:Risk Reduction Behavior; D014527:Uric Acid / Q000378:metabolism; D014528:Uricosuric Agents
D014528:Uricosuric Agents; D014527:Uric Acid