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Gout Treatment

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A Clinician's Pearls and Myths in Rheumatology

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Abstract

Treatment of gouty inflammation, hyperuricemia, and comorbidities are distinct but closely linked core elements of therapeutic strategy for patients with gout. All gout patients should be evaluated and treated for comorbid medical problems such as hypertension, metabolic syndrome, and coronary artery disease. Lifestyle modifications, including weight loss, are important adjuncts to pharmacologic urate lowering. The target serum urate level for urate-lowering therapy in most patients is less than 6.0 mg/dL. Serial monitoring of serum uric acid levels is essential, following the initiation of urate-lowering therapy. High-dose oral colchicine for the treatment of acute gout has an unacceptable risk:benefit ratio. Maintenance colchicine should be continued for at least the first 6 months of urate-lowering therapy. Allopurinol should not be initiated or discontinued during an acute gout flare. In most cases, allopurinol and other urate-lowering therapies should be continued for life.

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Authors and Affiliations

  1. University of Florida, Division of Rheumatology 100-277, Gainesville, Florida, 32610, USA

    N. Lawrence Edwards

  2. Medicine Department, Guy's and St. Thomas' Hospitals, 60B Copers Cope Road, Beckenham, Kent, BR31RJ, UK

    Terence Gibson

  3. Department of Rheumatology, Guy's Hospital, London, SE1 9RT, UK

    Terence Gibson

  4. VA Division of Rheumatology, VA Healthcare San Diego, University of California, San Diego, 3350 La Jolla Village Drive 111k, San Diego, CA, 92161, USA

    Robert A. Terkeltaub

Authors
  1. N. Lawrence Edwards
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  2. Terence Gibson
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  3. Robert A. Terkeltaub
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Editor information

Editors and Affiliations

  1. Clinical Rheumatology, Massachusetts General Hospital, 55 Fruit Street / Yawkey 2, Boston, MA, 02114

    John H. Stone (Director) (Director)

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© 2009 Springer Science+Business Media B.V.

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Edwards, N.L., Gibson, T., Terkeltaub, R.A. (2009). Gout Treatment. In: Stone, J.H. (eds) A Clinician's Pearls and Myths in Rheumatology. Springer, London. https://doi.org/10.1007/978-1-84800-934-9_36

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  • DOI: https://doi.org/10.1007/978-1-84800-934-9_36

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84800-933-2

  • Online ISBN: 978-1-84800-934-9

  • eBook Packages: MedicineMedicine (R0)

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