From the Guidelines
Gout is a type of inflammatory arthritis caused by the accumulation of excess urate crystals in joint fluid, cartilage, bones, tendons, bursas, and other sites, leading to joint swelling and pain during gout attacks. This condition is characterized by sudden, severe attacks of pain, swelling, redness, and tenderness, most commonly in the joint at the base of the big toe, and can also affect other joints including ankles, knees, elbows, wrists, and fingers 1. The management of gout includes both pharmacologic and nonpharmacologic approaches, with pharmacologic therapies focusing on urate-lowering strategies and anti-inflammatory drugs, and nonpharmacologic management focusing on dietary and lifestyle changes, including weight loss and exercise.
Some key points to consider in the management of gout include:
- The use of corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout, with a strong recommendation for low-dose colchicine when using colchicine to treat acute gout 1.
- The importance of discussing benefits, harms, costs, and individual preferences with patients before initiating urate-lowering therapy, including concomitant prophylaxis, in patients with recurrent gout attacks 1.
- The need to avoid initiating long-term urate-lowering therapy in most patients after a first gout attack or in patients with infrequent attacks, unless otherwise indicated 1.
- Lifestyle modifications, such as limiting alcohol consumption, avoiding purine-rich foods, maintaining a healthy weight, staying hydrated, and managing conditions like high blood pressure and diabetes, are also crucial in the management of gout.
The pathophysiology of gout involves the accumulation of excess urate crystals in joint fluid, cartilage, bones, tendons, bursas, and other sites, leading to joint inflammation and pain. Risk factors for gout include overweight or obesity, hypertension, alcohol intake, diuretic use, a diet rich in meat, seafood, and high-fructose food or drinks, and poor kidney function 1. With proper treatment and lifestyle modifications, it is possible to manage gout and prevent long-term joint damage and complications.
From the FDA Drug Label
Gout is a metabolic disorder which is characterized by hyperuricemia and resultant deposition of monosodium urate in the tissues, particularly the joints and kidneys. The etiology of this hyperuricemia is the overproduction of uric acid in relation to the patient's ability to excrete it 2
- Gout is a metabolic disorder
- Characterized by hyperuricemia
- Resultant deposition of monosodium urate in the tissues, particularly the joints and kidneys
- Caused by overproduction of uric acid in relation to the patient's ability to excrete it
From the Research
Definition of Gout
- Gout is an inflammatory arthritis that typically presents as acute onset, recurrent, monoarticular pain 3
- It is a common inflammatory arthritis affecting almost 6% of US males and 2% of US females 4
Causes of Gout
- The central cause of gout is deposition of monosodium urate crystals 4
- Hyperuricemia is a contributor to gout, and patient education on risk factors and contributors to hyperuricemia can improve the likelihood of successful therapy 3
Treatment of Gout
- Therapeutic options for treating acute flares include colchicine, nonsteroidal anti-inflammatory drugs, and corticosteroids 3
- Urate-lowering therapy with allopurinol or febuxostat is used after flare remission, and prophylaxis with a flare prevention medication, such as colchicine, can be administered 3
- Current treatments for urate-lowering therapy include allopurinol, febuxostat, probenecid, benzbromarone, and pegloticase 4