I have gout and experienced severe symptoms, including inability to walk, prompting a blood test to check uric acid levels and blood sugar on a Sunday, what are the next steps?

From the Guidelines

I strongly recommend that you keep your appointment with your doctor to discuss your gout and blood test results, and in the meantime, consider taking over-the-counter anti-inflammatory medications like ibuprofen (400-800mg every 6-8 hours with food) if not contraindicated for you, as suggested by the American College of Physicians guideline 1. While waiting for your appointment, you can also try to manage your symptoms by:

• Applying ice to the affected joint for 20 minutes several times daily
• Elevating the painful area
• Drinking plenty of water
• Avoiding alcohol and foods high in purines like red meat, seafood, and organ meats Gout occurs when uric acid crystals build up in joints, causing intense pain and inflammation, typically in the big toe. Your blood tests will help determine your uric acid levels and blood sugar, which can influence gout management. According to the 2016 updated EULAR evidence-based recommendations for the management of gout 1, it is essential to be fully informed about the disease, its treatment, and associated comorbidities. When you see your doctor, they may prescribe specific medications to reduce pain and inflammation, such as colchicine, NSAIDs, or corticosteroids, as recommended by the American College of Physicians guideline 1. They may also consider long-term medications to prevent future attacks. Be prepared to discuss your symptoms, their duration, and what makes them better or worse. Additionally, your doctor may advise you on lifestyle changes, such as weight loss, exercise, and dietary modifications, to help manage your gout, as suggested by the EULAR recommendations 1.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Gout Diagnosis and Management

• Gout is caused by monosodium urate crystal deposition in joints and tissues, and its diagnosis can be made using several validated clinical prediction rules 2.
• Risk factors for gout include male sex, obesity, hypertension, alcohol intake, and a diet rich in meat and seafood 2.
• Acute gout flares are often managed with steroids, non-steroidal anti-inflammatory drugs, or colchicine 3.
• Long-term management of gout includes lifestyle modifications, such as weight loss, avoidance of alcohol, and purine-rich foods, as well as urate-lowering therapy (ULT) 3.

Urate-Lowering Therapy (ULT)

• ULT is indicated in patients with 2 or more gout flares per year, tophi, or radiographic evidence of gouty arthropathy 3.
• Allopurinol is the first-line ULT agent, but it carries a risk of inducing severe cutaneous adverse reactions, especially in patients with chronic kidney disease and patients harboring the HLA-B*5801 allele 3.
• Other ULT agents include febuxostat and probenecid, and ULT is usually titrated to achieve goal serum uric acid (SUA) levels below 6 mg/dL 3.

Blood Tests and Monitoring

• Blood tests, such as serum uric acid levels, can be used to monitor gout and adjust treatment as needed 2.
• Regular monitoring of blood sugar levels is also important, especially in patients with diabetes or those taking medications that can affect blood sugar control 2.

Treatment Options

• Treatment options for gout include colchicine, nonsteroidal anti-inflammatory drugs, and corticosteroids for acute flares, as well as ULT for long-term management 4.
• Novel therapies, such as IL-1β antagonists and uricosurics, are also being developed and may be effective for patients with recalcitrant gout 5.