title: Advances in pharmacotherapy for the treatment of gout.
abstract: BACKGROUND
  Gout is a common inflammatory arthritis affecting almost 6% of US males and 2% of US females. The central cause of gout is deposition of monosodium urate crystals, and the focus of treatment is aimed at crystal dissolution using urate-lowering therapy.
  
  
  METHODS
  The review describes the current treatments for urate-lowering therapy including allopurinol, febuxostat, probenecid, benzbromarone and pegloticase. Anti-inflammatory treatment of acute flares and prophylaxis of flares with NSAIDs, colchicine, corticosteroids and anti-IL-1 agents is also reviewed. In addition, drugs in Phase III clinical trials for gout indications are reviewed.
  
  
  CONCLUSIONS
  In the last decade, there has been major progress in the pharmacotherapy of gout. Management guidelines have emphasized the importance of a therapeutic serum urate target for effective gout management. Studies have identified the safe and effective dosing strategies for 'old' drugs such as allopurinol and colchicine. New therapeutic agents have been developed and approved for both urate-lowering therapy and anti-inflammatory treatment of acute flares. However, quality of care remains a major challenge in gout management, and strategies to ensure best practice require further focus to ensure that the progress of the last decade translates into clinical benefit for people with gout.
authors.affiliation: University of Queensland, Queensland Brain Institute, Centre for Neurogenetics and Statistical Genomics , Queensland , Australia.
authors.forename: Philip C
authors.initials: PC
authors.lastname: Robinson
authors.forename: Nicola
authors.initials: N
authors.lastname: Dalbeth
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001553:Benzbromarone / Q000627:therapeutic use; D017326:Clinical Trials, Phase III as Topic; D003078:Colchicine / Q000627:therapeutic use; D000069465:Febuxostat; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage; D006801:Humans; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011339:Probenecid / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D014503:Urate Oxidase / Q000627:therapeutic use; D014527:Uric Acid / Q000378:metabolism
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D006074:Gout Suppressants; D013844:Thiazoles; D000069465:Febuxostat; D014527:Uric Acid; C541220:canakinumab; D011092:Polyethylene Glycols; D001553:Benzbromarone; D000493:Allopurinol; D014503:Urate Oxidase; D011339:Probenecid; C031545:Pegloticase; D003078:Colchicine
keywords: allopurinol; febuxostat; gout; pegloticase; probenecid; urate