title: The practical management of gout.
abstract: Gout management requires a comprehensive strategy that considers both acute and chronic aspects of the disease. Acute gout flares should be treated with anti-inflammatory agents as rapidly as possible. The underlying hyperuricemia may be treated with urate-lowering agents initiated at a time appropriate for the individual patient. Successful urate lowering ultimately prevents flares and disease progression and should be started immediately in patients with advanced or tophaceous disease. When urate-lowering therapy is initiated, anti-inflammatory prophylaxis should be used to reduce the risk of flares induced by abrupt changes in urate levels. Regular monitoring of serum urate can ensure therapeutic dosing of urate-lowering agents to achieve levels below 6 mg/dL, which are associated with a reduction in flares and tophi.
authors.affiliation: University of Pennsylvania, Philadelphia, PA, USA. schumacr@mail.med.upenn.edu
authors.forename: H Ralph
authors.initials: HR
authors.lastname: Schumacher
authors.forename: Lan X
authors.initials: LX
authors.lastname: Chen
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D005938:Glucocorticoids / Q000627:therapeutic use*; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids; D006074:Gout Suppressants