Gout: an evidence-based review.

  title={Gout: an evidence-based review.},
  author={Lan X. Chen and H. Ralph Schumacher},
  journal={Journal of clinical rheumatology : practical reports on rheumatic \& musculoskeletal diseases},
  volume={14 5 Suppl},
  • Lan X. Chen, H. Schumacher
  • Published 1 October 2008
  • Medicine, Psychology
  • Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases
bout 1% of individuals studied in Western populations will develop gout during their lifetime. Gout has a well-understood pathogenesis and effective treatments, but re-mains suboptimally managed. 1–3 This review will emphasize recent developments related to gout epidemiology, pathogenesis, diagnosis, and efficacy of existing therapies. In each of these areas, we identify evidence, persisting gaps in evidence, and address clinical implications. 

Be cautious when treating gout in patients with renal impairment

Although the overall treatment of gout is very similar in patients with or without renal impairment, special precautions must be taken to avoid adverse effects related to renal impairment.

Febuxostat treatment for gout: what the clinician needs to know

This short review covers general principles of the management of gout and then focuses on practical aspects and use of febuxostat.

Study on the diagnosis of gout with xanthine and hypoxanthine

Xanthine and hypoxanthine, as precursors of uric acid, have been reported to be high in gout patients with hyperuricemia and presumed to be gout biomarkers.

The current state of care in gout: Addressing the need for better understanding of an ancient disease

Gout is increasingly recognized as a prevalent chronic disease state requiring appropriate long‐term management while controlling for risk factors and comorbid conditions, and effective treatment options can help gout patients achieve therapeutic SUA targets to control gout flares and prevent potentially destructive disease manifestations.

Managing gout: not a trivial matter

An overview of the pathophysiology of gout is given and practice nurses can help patients understand gout and encourage lifestyle changes and treatment adherence.

A Systematic Review of the Economic and Humanistic Burden of Gout

The evidence confirms that gout has a growing overall prevalence and represents a significant burden in terms of both direct healthcare cost and health-related quality of life (HRQL) outcomes.

Gout: No Longer the Disease of Kings

Gout can lead to inflammation and damage to cartilage, bone, bursa, tendons, heart, or kidneys, and some people with gout will progress to chronic gout with tophi deposits, pain, deformity, and bone and cartilage destruction.


Gout is the most prevalent inflammatory arthritis and affects 2.5% of the general population in the UK, and is the only arthritis that has the potential to be cured with safe, inexpensive and well tolerated urate-lowering treatments, which reduce serum uric acid by either inhibiting xanthine oxidase – e.g. allopurinol or by increasing the renal excretion of uric Acid.

Rhazes viewpoints about causes, diagnosis, treatment and prognosis of gout

Generally most of Rhazes viewpoints about gout are correct and compatible with recent findings and more investigation on Rhazes’ viewpoints can guide us to propose more reliable hypothesis and schematize cost effective studies by delving into past medical records.



New developments in the epidemiology and genetics of gout

The prevalence of gout appears to be rapidly increasing worldwide and is no longer a disorder suffered primarily by over-fed alcohol consumers. Emerging risk factors include longevity, metabolic

Corticotropin for Acute Management of Gout

Corticotropin alone or in combination with colchicine was more rapidly effective and associated with fewer adverse effects than indomethacin and this regimen may be considered an alternative, especially for patients with medical problems in which other regimens are contraindicated.

A survey of current evaluation and treatment of gout.

Combination antiinflammatory agents are used frequently for acute gout despite absence of evidence in the literature to support this practice, supporting the need for longterm prospective, placebo controlled studies to provide more evidence-based guidance.

Withdrawal of allopurinol in patients with gout.

A few years ago the possibility was raised that allopurinol therapy might lead to the incorporation of abnormal genetic material into cell nuclei, but it subsequently appears that this eventuality does not in fact occur and that the second is of no clinical significance.

Systemic steroid therapy for acute gout: a clinical trial and review of the literature.

Does colchicine work? The results of the first controlled study in acute gout.

Two-thirds of colchicine-treated patients improved after 48 hours, but only one-third of the patients receiving placebo demonstrated similar improvement; significant differences from placebo were shown after 18-30 hours.

Treatment of chronic gout. Can we determine when urate stores are depleted enough to prevent attacks of gout?

A majority of patients were able to deplete urate crystal stores in their knee joint fluids when their SUA levels were kept to < or = 6 mg/dl for several years, suggesting patients with chronic gout need serum urate concentrations to be kept low to prevent further attacks.

Pathogenesis of Gout

Lifestyle modifications that are recommended for gout generally align with those for major chronic disorders (such as the insulin resistance syndrome, hypertension, and cardiovascular disorders); thus, these measures may be doubly beneficial for many patients with gout and particularly for individuals with these comorbid conditions.

Diversity of opinions on the management of gout in France. A survey of 750 rheumatologists.

The data demonstrate that French rheumatologists have widely diverging views on how to treat gout, and whether a waiting period is needed between an acute attack and initiation of urate-lowering therapy, and how long this period should be, are unsettled issues that deserve to be studied.

Preliminary criteria for the classification of the acute arthritis of primary gout.

The American Rheumatism Association sub-committe on classification criteria for gout analyzed data from more than 700 patients with gout, pseudogout, rheumatoid arthritis, or septic arthritis.