Update on diagnosis and management of gout

Abstract

• Objective: To review the diagnosis and management of gout. • Methods: Review of the literature and case study. • Results: Gout is a curable disease. The clinical stages of gout (hyperuricemia, acute gout, intercritical gout, chronic gout) represent different opportunities for management. The choice of therapy should tailored to the individual based on underlying comorbidities and potential contraindications. Intercritical gout is an opportunity to use the new recommended dosing regimen for colchicine, initiate urate-lowering therapy, and screen for comorbidities such as cardiovascular disease that often accompany gout. Treating to a target serum urate level < 6 mg/dL is applicable to all patients with established gout. More aggressive therapy should be considered in patients with chronic tophaceous gout, as tophi are an indicator of large crystal burden that can cause significant joint destruction, disability, and chronic pain. • Conclusion: Despite advances in the understanding and management of gout, patients continue to incur debilitating disease. Patient education and better provider-patient communication are imperative for successful management. Copyright 2012 by Turner White Communications Inc. All rights reserved.