Gout Treatment

  • N. Lawrence Edwards
  • Terence Gibson
  • Robert A. Terkeltaub


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.


Serum Urate Acute Gout Gout Patient Serum Urate Level Gout Flare 
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Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  • N. Lawrence Edwards
    • 1
  • Terence Gibson
    • 2
    • 3
  • Robert A. Terkeltaub
    • 4
  1. 1.University of FloridaDivision of Rheumatology 100-277GainesvilleUSA
  2. 2.Medicine DepartmentGuy's and St. Thomas' HospitalsBeckenhamUK
  3. 3.Department of RheumatologyGuy's HospitalLondonUK
  4. 4.VA Division of Rheumatology, VA Healthcare San DiegoUniversity of CaliforniaSan DiegoUSA

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