The treatment of gout

Abstract

Gout is usually the most treatable of the arthritides. Acute attacks, if caught early enough, can 'be eradicated rapidly and completely. Recurrences can be prevented, and tophi dissolved. The drugs capable of producing these effects are well known. The purpose of this brief review of the therapy of gout is to consider both the basic principles of treatment and some of the newer aspects of the clinical pharmacology of these agents.Traditionally, the treatment of gout is divided into three parts: a) control of the acute episode, b) prevention of subsequent attacks, and c) dissolution of tophaceous deposits by reducing the serum urate level to normal. This subdivision of therapy is still conceptually valid.

Drug Therapy of Urinary Calculi and Prevention of Recurrence

“…Numerous authors have since confirmed these findings (Boss and SEEGMILLER 1979;KAVALACH 1974;MIANO et aI. 1979;SPERLING and DE VRIES 1964;WALLACE 1978;FELLSTROM 1984).…”

Intravenous colchicine in the treatment of acute pseudogout

“…The dosage regimen of intravenous colchicine used in this study has long been an accepted method of administration (5,23,24). Nevertheless it has been pointed out by Wallace that a single intravenous dose of 3 mg would be safer but equally effective because leukocyte drug levels remain stable and high for more than 24 hours when the single-dose method is used (25). Although we have not evaluated that method, current rheumatologic opinion favors the single dose in view of the potential dangers of toxicity in using repeated and frequent doses (Wallace SL, McCarty DJ, Malawista SE, personal communications).…”

The Effect of Size of Materials Formed or Implanted In Vivo on the Macrophage Response and the Resultant Influence on Clinical Outcome

“…Not knowing the exact mechanisms makes it difficult to select appropriate strategies or even understand how they work. Prevention strategies either try to control the crystallization phase or limit the inflammatory phase, with current drug therapy mostly related to the inflammatory phase [ 25 , 41 ]. All current prevention drugs are aimed at reducing the uric acid concentration by increasing excretion or reducing production [ 25 , 41 , 42 ].…”

“…Prevention strategies either try to control the crystallization phase or limit the inflammatory phase, with current drug therapy mostly related to the inflammatory phase [ 25 , 41 ]. All current prevention drugs are aimed at reducing the uric acid concentration by increasing excretion or reducing production [ 25 , 41 , 42 ]. In some cases, this can actually trigger an attack (possibly by creating more nucleation sites) [ 43 ].…”