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Understanding treatments for gout Cannella AC; Mikuls TRAm J Manag Care 2005[Nov]; 11 (15 Suppl): S451-8; quiz S465-8Gout is one of the most readily manageable of the rheumatic diseases. This article reviews basic pathways in purine metabolism, uric acid handling, and the pathogenic mechanism of clinical gout, as well as the areas in those pathways amenable to intervention. Attention is also given to associated comorbidities, such as hyperuricemia and obesity, hypertension, hyperinsulinemia, and coronary artery disease. The significance of lifestyle modifications, such as weight loss and alcohol reduction, is discussed as an important adjunct to pharmacotherapy in gout. Current and investigational agents used in gout management are also reviewed. Finally, treatment recommendations for acute and chronic gout are suggested.|Acute Disease[MESH]|Adrenal Cortex Hormones/therapeutic use[MESH]|Behavior Therapy[MESH]|Chronic Disease[MESH]|Colchicine/therapeutic use[MESH]|Female[MESH]|Gout Suppressants/therapeutic use[MESH]|Gout/diagnosis/etiology/metabolism/*therapy[MESH]|Health Behavior[MESH]|Humans[MESH]|Hyperuricemia/complications/drug therapy/metabolism[MESH]|Male[MESH]|Practice Guidelines as Topic[MESH]|Purines/metabolism[MESH]|Risk Factors[MESH]|Uric Acid/metabolism[MESH] |
