First, new pharmaceutical treatment options have become available and the evidence base for the efficacy and safety of available drugs has expanded. Phosphoribosylpyrophosphate and purine metabolism in cultured fibroblasts, The spectrum of inherited mutations causing HPRT deficiency: 75 new cases and a review of 196 previously reported cases, Glycogen storage disease manifested as gout and myopathy: three case reports and literature review, Uromodulin mutations causing familial juvenile hyperuricaemic nephropathy lead to protein maturation defects and retention in the endoplasmic reticulum, Common dysfunctional variants in ABCG2 are a major cause of early-onset gout, Polymorphisms of uric transporter proteins in the pathogenesis of gout in a Chinese Han population, Nature versus nurture in gout: a twin study, Initiation of allopurinol at first medical contact for acute attacks of gout: a randomized clinical trial, A retrospective study of the relationship between serum urate level and recurrent attacks of gouty arthritis: evidence for reduction of recurrent gouty arthritis with antihyperuricemic therapy, Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout, A two-stage approach to the treatment of hyperuricemia in gout: the “dirty dish” hypothesis, Urate as a predictor of the rate of clinical decline in Parkinson disease, Serum uric acid and cognitive function and dementia, The relationship between uric acid levels and Huntington's disease progression, Uric acid levels predict survival in men with amyotrophic lateral sclerosis, The risk of Parkinson disease associated with urate in a community-based cohort of older adults, Preventing attacks of acute gout when introducing urate-lowering therapy: a systematic literature review, Effects of febuxostat versus allopurinol and placebo in reducing serum urate in subjects with hyperuricemia and gout: a 28-week, phase III, randomized, double-blind, parallel-group trial, The urate-lowering efficacy and safety of febuxostat in the treatment of the hyperuricemia of gout: the CONFIRMS trial, Up-titration of allopurinol in patients with gout, Cost-effectiveness of febuxostat in chronic gout, Cost-effectiveness of allopurinol and febuxostat for the management of gout, Clinical and health care use characteristics of patients newly starting allopurinol, febuxostat, and colchicine for the treatment of gout, Clinical pharmacogenetics implementation consortium guidelines for human leukocyte antigen-B genotype and allopurinol dosing, Allopurinol pharmacogenetics: assessment of potential clinical usefulness, Severe allopurinol toxicity.
From Stamp LK et al. There is no research evidence to support the use of corticosteroids for flare prophylaxis. Other national and regional guidelines include the US Agency for Healthcare Research and Quality's 2014 guidelines for Diagnosis of Gout and Management of Gout [37, 38], and the Australian and New Zealand [39] and Portuguese [40] recommendations for the diagnosis and management of gout that arose from the 3e initiative [36]. FitzGerald JD, Dalbeth N, Mikuls T, et al.
This study, however, does not take into account the ongoing silent deposition of crystals and the significant pain experienced by patients with each attack. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis, 2012 American College of Rheumatology guidelines for management of gout. A retrospective study of patients seen by rheumatologists in Taiwan suggested that the age at which gout presents was falling [112] and heritability accounts for 35% of gout risk in men and 17% in women in Taiwan [1]. Accreditation is valid for 5 years from 10 June 2013. Single gene disorders associated with urate overproduction, hyperuricaemia and accelerated purine synthesis de novo (such as glycogen storage diseases and Lesch–Nyhan syndrome) are very rare causes of primary gout. For patients on diuretic therapy presenting with acute gout, should diuretic therapy be discontinued? 1) illustrates the suggested care pathway. It is now recommended that an NSAID or colchicine are both drugs of choice for acute gout when there are no contraindications and that the choice of first-line agent should be determined by renal function, co-morbidities and patient preference (recommendation III for the management of acute attacks). Patients should be fully involved in the decision as to when to commence ULT. The median dose of allopurinol found to be required to achieve the less stringent therapeutic sUA target of ⩽360 µmol/l in >90% of the Nottingham patients was 400 mg/day.