title: Gout and its comorbidities: implications for therapy.
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.
authors.affiliation: Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch 8140, New Zealand. lisa.stamp@cdhb.govt.nz
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Stamp
authors.forename: Peter T
authors.initials: PT
authors.lastname: Chapman
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D003078:Colchicine / Q000627:therapeutic use; D006073:Gout / Q000150:complications* / Q000188:drug therapy; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D012307:Risk Factors
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D003078:Colchicine