The Modern Management of Gout: A Fresh Look at an Age-old Disease

Introduction

Gout is an inflammatory disease of metabolic origins that has been recognized since ancient times and is the most common type of inflammatory arthritis in men over 40, although the number of post menopausal females affected is also increasing. Gout is thought to affect between 3–5 million individuals in the United States and is increasing in prevalence and incidence. The disease is defined by deposition of monosodium urate crystals in the joints and other connective tissues. Hyperuricemia is the main risk factor for gout, with prevalence of gouty arthritis increasing with increasing serum urate levels. Other risk factors include hereditary, alcohol consumption, high purine dietary intake, hypertension, obesity, increasing use of predisposing medication such as thiazides, diuretics, low dose aspirin and the increasing prevalence of end stage renal disease.

Urate lowering therapy is critical in the long-term treatment of gout. Traditional approaches to the management of hyperuricemia had not changed much over many years, until the recent introduction of a new treatment which provides alternative therapeutic choices. The successful management of gout requires a strategy to treat both the acute flares and to control hyperuricemia in the long term. Treatment should be individualized based on disease progression and presence of comorbid illnesses such as chronic kidney disease, metabolic syndrome, etc. Patient compliance with their treatment and life-style modifications, are also of vital importance in order to optimize clinical outcomes.

This Virtual Grand Rounds discusses the key challenges involved in managing gout, there are 4 modules covering:

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