Recovery of patients with gout

Abstract

Introduction. The incidence and prevalence of gout have increased worldwide in recent decades. Scientists at the Rochester Epidemiology Project (MN, USA) have seen a two-fold increase in the incidence of primary gout (patients without diuretic exposure) over a 20-year period, which ended in 1996. The increase of incidence may be related due to the difficulty and often unsatisfactory treatment options. The aim of the study was to systematize the recommendations on dietary treatment, and medication for patients with gout. Materials and methods. An analytical, qualitative, and secondary study was performed in the form of a synthesis article. 115 sources were identified and analyzed; from this list, 44 sources were selected according to the impact score during the publication period and according to the level of recommendations. Results. 44 articles were included. Most studies were small, retrospective analyses performed in single centers, with concerns for bias. Eleven studies (including five randomized controlled trials) reported improved patient outcomes following pharmacological interventions with known efficacy in gout, including allopurinol, prednisolone, NSAIDs and anakinra. Eight studies reported improved outcomes associated with non-pharmacological interventions: inpatient rheumatology consultation and a hospital gout management protocol. No studies to date have prospectively evaluated strategies designed to prevent re-admissions of patients hospitalized for gout flares. Conclusions. Urate crystals is completely soluble when we can lower the serum level of uric acid to normal values, but this often requires long-term treatment. The early onset of rehabilitation of affected joints helps to reduce the articular inflammatory process, the pain syndrome and it delays the progression of the underlying pathology while improving the quality of life in patients with gout. Further research is needed to enable healthcare providers to individualize and optimize gout treatment strategies, ensuring that patients with gout receive effective, safe, and high-quality care.

"Clinical and Evolutive Features of Gouty Arthritis"

“…Of these, 11 people constantly took diuretics. The formation of urates can also be affected by the insufficient function of ammoniogenesis in the kidneys, manifested by aciduria and crystallization of UA 1,17 , caused by the presence of any renal pathology, as well as associated with obesity, often prior to gout, in patients in our study 11,13,17 .…”

“…As mentioned above, dietary recommendations for those suffering from gout have recently been significantly reviewed. According to our data, in 73% of cases, patients with gout receive dietary recommendations, including the decrease of the use of meat products 16,17 .…”

“…Our study observed a high frequency of alcohol consumption and purine-rich foods among patients with gout over 60 years old, which is considered one of the main risk factors for gout in elderly patients, confirmed by others studies to 5,8,14 . A significantly higher number of alcohol abusers among people suffering from gout is noted by many authors and continues to be a risk factor for a severe course of gout 11,16,17 .…”

“…In patients over 65 years old, a high incidence of coronary heart disease, type 2 diabetes, arterial hypertension, chronic heart failure, CKD was determined. The authors did not consid er the age of onset of gout, although in the group of more than 65 years old, the duration of the disease was significantly longer (two times) compared to the younger group 6,8,[15][16][17] .…”

“…The greater use of acetylsalicylic acid in small doses, both before and after the onset of gout, in elderly patients is indisputable. The need for a strict monitoring of the level of UA in these patients is shown in many studies, which have revealed an increase in the risk of recurrent gouty attacks when taking low doses of acetylsalicylic acid 8,10,14,17 . In recent years, the validity of acetylsalicylic acid prophylaxis of thrombotic complications in elderly patients has been questioned.…”