Management of Geriatric Gout

  • Lan X. ChenEmail author


The incidence of gout increases with age and it is related to comorbidities and longevity. It is especially important for those caring for our aging population to provide accurate diagnosis, and adequate and effective treatment [1]. Hyperuricemia and gout are associated with cardiovascular disease and other features such as the metabolic syndrome [2] occur more often as renal function (and urate clearance) declines as it does during aging. Acute painful gouty arthritis can be induced with the use of needed drugs in elderly patients such as diuretics. Gout, although uncommon in premenopausal women, occurs commonly in women past the menopause. This is in part due to the loss of the urate-lowering effect of estrogen. Although the general features of effective treatment have changed little, some detail can allow improved use of current modalities. In addition, some newer agents are becoming available and are important to understand.


Gout Hyperuricemia Aging 


  1. 1.
    Mikuls TR, Farrar JT, Bilker WB, et al. Gout epidemiology: results from the UK General Practice Research Database, 1990–1999. Ann Rheum Dis. 2005;64:267–72.PubMedCrossRefGoogle Scholar
  2. 2.
    Baker JF, Krishnan E, Chen LX, Schumacher HR. Serum uric acid and cardiovascular disease: recent developments and where do they leave us? Am J Med. 2005;118(8):816–26.PubMedCrossRefGoogle Scholar
  3. 3.
    Schumacher Jr HR, Edwards LN, Perez-Ruiz F, Becker M, Chen LX, Furst DE, et al. Outcome measures for acute and chronic gout. J Rheumatol. 2005;32(12):2452–5.PubMedGoogle Scholar
  4. 4.
    Chen LX, Schumacher HR. Management of gout. J Clin Outcomes Manag. 2003;10(6):336–42.Google Scholar
  5. 5.
    Schumacher Jr HR, Boice JA, Daikh DI, Mukhopadhyay S, Malmstrom K, Ng J, et al. Randomised double blind trial of etoricoxib and indometacin in treatment of acute gouty arthritis. BMJ. 2002;324(7352):1488–92.PubMedCrossRefGoogle Scholar
  6. 6.
    Li-Yu J, Clayburne G, Sieck M, Beutler A, Rull M, Eisner E, et al. Treatment of chronic gout. Can we determine when urate stores are depleted enough to prevent attacks of gout? J Rheumatol. 2001;28(3):577–80.PubMedGoogle Scholar
  7. 7.
    Wurzner G, Gerster JC, Chiolero A, et al. Comparative effects of losartan and irbesartan on serum uric acid in hypertensive patients with hyperuricaemia and gout. J Hypertens. 2001;19:1855–60.PubMedCrossRefGoogle Scholar
  8. 8.
    Feher MD, Hepburn AL, Hogarth MB, et al. Fenofibrate enhances urate reduction in men treated with allopurinol for hyperuricaemia and gout. Rheumatology (Oxford). 2003;42:321–5.CrossRefGoogle Scholar
  9. 9.
    Choi HK, Liu S, Curhan G. Intake of purine-rich foods, protein, and dairy products and relationship to serum levels of uric acid: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2005;52:283–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Jacob RA, Spinozzi GM, Simon VA, et al. Consumption of cherries lowers plasma urate in healthy women. J Nutr. 2003;133:1826–9.PubMedGoogle Scholar
  11. 11.
    Emmerson BT. Effects of oral fructose on urate production. Am Rheum Dis. 1974;33:276–80.CrossRefGoogle Scholar
  12. 12.
    Sundy JS, Garson N, Kelly J, et al. A Phase I study of pegylated uricase (Puricase®) in subjects with gout. Arthritis Rheum. 2004;50(Suppl):S337–8. Abstract.Google Scholar
  13. 13.
    Baraf HSB, Kim S, Matsumoto AK, et al. Resolution of tophi with intravenous Peg-uricase in refractory gout. Arth Rheum. 2005;52(Suppl):S105. Abstract.Google Scholar
  14. 14.
    Becker MA, Schumacher HR, Wortmann RL, et al. Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase. A twenty-eight-day, multicenter, phase II, randomized, double-blind, placebo-controlled, dose-response clinical trial examining safety and efficacy in patients with gout. Arthritis Rheum. 2005;52:916–23.PubMedCrossRefGoogle Scholar
  15. 15.
    Becker MA, Schumacher HR, Wortman RL, et al. Febuxostat compared with allopurinol in patients with hyperuricemia and gout. N Eng J Med. 2005;353:2450.CrossRefGoogle Scholar
  16. 16.
    Briesacher BA, Andrade SE, Fouayzi H, Chan KA. Comparison of drug adherence rates among patients with seven different medical conditions. Pharmacotherapy. 2008;28(4):437–43.PubMedCrossRefGoogle Scholar
  17. 17.
    Wu EQ, Patel PA, Yu AP, Mody RR, Cahill KE, Tang J, et al. Disease-related and all-cause health care costs of elderly patients with gout. J Manag Care Pharm. 2008;14(2):164–75.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Penn Presbyterian Medical CenterPhiladelphiaUSA

Personalised recommendations