Gout is one of the most painful rheumatic conditions. For many people, the first gout attack occurs in the big toe, but many other joints can be affected by gout disease. In 2002, there were nearly 4 million outpatient visits in the United States related to gout. According to a report in the September 15, 2007 issue of American Family Physician (AFP), even though gout is well-understood and easily diagnosed, the quality of treatment may be less than optimal for up to half of patients with gout.
Gout develops from an accumulation of excess uric acid in the body which causes monosodium urate crystal deposition in the joints. Excess uric acid can result from increased uric acid production or decreased elimination of uric acid from the body. Certain purine-rich foods can cause an increase in uric acid levels. Some medications also can cause increased uric acid levels.
First-line treatment for acute gout is nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids depending on other conditions the patient may have. Colchicine is considered second-line therapy. For chronic gout, allopurinol is the most common treatment. There are also new therapeutic options for gout in development. The AFP update on gout points out that Febuxostat, a nonpurine xanthine oxidase antagonist and Puricase (PEG-uricase), a pegylated uricase enzyme are in clinical trials and perhaps will lead to more treatment options for gout in the future.
More Related Resources:
- Guide to Gout
- Fast Facts About Gout
- Test Your Knowledge: Gout
- Gout 101: Free Newsletter E-Course
- 10 Things You Should Know About Gout
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