title: [The clinical picture of gout is changing].
abstract: The prevalence of gout in the western countries is 1-2%. The disease has become more common during the last two decades, and the same time its clinical picture has changed. The disease is often polyarticular, the patients are older than before and they have more often associated cardiovascular diseases and renal insufficiency. Effective treatment of acute gout is nonsteroidal anti-inflammatory drugs with intra-articular or systematic corticosteroids. The goal for the treatment of intermittent and chronic gout is to maintain serum urate concentration velow 360 micromol/l by diet and by antihyperuricemic meditation, primarly allopurinole and probenecid. Febuxostat is a new xanthine oxidase inhibitor, which will be available for the treatment of refractory gout in the near future. Special attention should be paid on detecting and treating cardiovascular diseases and their risk factors in patients with gout.
authors.affiliation: HYKA, medisiininen tulosyksikkoö, Vantaa.
authors.forename: Heikki
authors.initials: H
authors.lastname: Julkunen
authors.forename: Yrjö T
authors.initials: YT
authors.lastname: Konttinen
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology; D004032:Diet; D000069465:Febuxostat; D006073:Gout / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D011339:Probenecid / Q000627:therapeutic use; D012307:Risk Factors; D013844:Thiazoles / Q000627:therapeutic use; D014528:Uricosuric Agents / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D013844:Thiazoles; D014528:Uricosuric Agents; D000069465:Febuxostat; D000493:Allopurinol; D011339:Probenecid