04. tbl. 104. árg. 2018

Gout – a treatable condition

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Gout is a disabling and common arthritis with increasing prevalence. Without treatment the disease can cause permanent joint damage. It is commonly associated with the metabolic syndrome but can also be related to a number of life-threatening diseases and their treatments. Gout is often misdiagnosed and its long-term management is suboptimal despite the availability of effective treatments. Recently The American College of Rheumatology (ACR) and European League against Rheumatism (EULAR) released common guidelines for the diagnosis of gout and EULAR updated their guidelines for management. There is increased emphasis on preventive treatment, both with lifestyle modifications and pharmacotherapy. It is important to educate patients about the disease and the existence of effective treatment options, how to manage an acutely inflamed joint and why it is important to lower serum urate. When a patient is diagnosed with gout he should be screened for associated comorbidities. It is important to treat-to-target and lower serum urate over a long period of time to induce permanent remission of gouty arthritis.

Table I: Gout classification criteria. Redrawn and translated from ACR / EULAR guidelines 2015. Eight points suffice to make the diagnosis.

Table II: Risk factors for gout.

Table III: Recommendations for the treatment of gout.

Figure 2: Management of an acute flare of gout. Translated from EULAR updated recommendations from 2016.6

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