Update on gout and hyperuricemia.
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.
Baker
J F
JF
Department of Medicine, Division of Rheumatology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA. bakerjo@uphs.upenn.edu
Schumacher
H Ralph
HR
D000208:Acute Disease; D002318:Cardiovascular Diseases / Q000209:etiology; D002908:Chronic Disease; D017281:Cost of Illness; D042241:Early Diagnosis; D006073:Gout / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D033461:Hyperuricemia / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007674:Kidney Diseases / Q000209:etiology; D011788:Quality of Life; D012307:Risk Factors
D006074:Gout Suppressants