Gout

A condition marked by increased levels of uric acid in the blood, joints, and tissue. The buildup of uric acid in the joints and tissues causes arthritis and inflammation. NIH - National Cancer Institute

About Gout

Gout is a painful condition that occurs when the bodily waste product uric acid is deposited as needle-like crystals in the joints and/or soft tissues. In the joints, these uric acid crystals cause inflammatory arthritis, which in turn leads to intermittent swelling, redness, heat, pain, and stiffness in the joints.

In many people, gout initially affects the joints of the big toe (a condition called podagra). But many other joints and areas around the joints can be affected in addition to or instead of the big toe. These include the insteps, ankles, heels, knees, wrists, fingers, and elbows. Chalky deposits of uric acid, also known as tophi, can appear as lumps under the skin that surrounds the joints and covers the rim of the ear. Uric acid crystals can also collect in the kidneys and cause kidney stones... NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases

What works? Research summarized

Evidence reviews

Efficacy and safety of benbromarne and allopurinol for primary gout ULT: a meta-analysis

Bibliographic details: Shao L, Wei L.  Efficacy and safety of benbromarne and allopurinol for primary gout ULT: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2012; 12(6): 722-726 Available from: http://www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=201206018

Effectiveness of interventions for the treatment of acute and prevention of recurrent gout: a systematic review

The authors concluded that there is a lack of robust data and a need to re-evaluate treatments for gout. Review methods were incompletely reported but, overall, the authors' conclusions about the lack of adequate evidence appear to reflect the limited data identified.

Treatment of acute gout: a systematic review

OBJECTIVE: Acute gout is traditionally treated with NSAIDs, corticosteroids, and colchicine; however, subjects have multiple comorbidities that limit the use of some conventional therapies. We systematically reviewed the published data on the pharmacologic and non-pharmacologic agents used for the treatment of acute gouty arthritis.

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Summaries for consumers

Systemic corticosteroids for acute gout

‐ there is no precise information about side effects and complications. Only a minority of the patients treated with the steroid oral prednisolone reported minor side effects.

Intra‐articular glucocorticoids for acute gout

This summary of a Cochrane review presents what we know from research about the effect of glucocorticoid injections (into affected joints) in people with acute gout. There were no trials that met our inclusion criteria, and no trials measuring the effect on pain, inflammation, the number of withdrawals due to adverse events, function, quality of life, treatment success and serious adverse events. Studies of glucocorticoid injections in other conditions that lead to joint pain suggest that this therapy may be well tolerated, relatively safe and effective in relieving pain.

Pegloticase for chronic gout

‐        it is unknown whether pegloticase can improve the pain and function of people with chronic gout.

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Terms to know

Chondrocalcinosis (Pseudogout)
A condition often mistaken for gout that results from the deposit of calcium phosphate crystals (not uric acid crystals as in gout) in the joints and other tissues.
Hyperuricemia
The presence of elevated levels of uric acid in the blood.
Podagra
Gout in the big toe.
Purines
One of two chemical compounds that cells use to make the building blocks of DNA and RNA. Examples of purines are adenine and guanine. Purines are also found in meat and meat products. They are broken down by the body to form uric acid, which is passed in the urine. High levels of uric acid in the body may cause gout.
Tophi
Nodular masses of uric acid crystals that sometimes form in the soft tissue of people with chronic gout. Although tophi are most common around the fingers, elbows, and big toe, they can occur in virtually any part of the body. (The singular is tophus.)
Uric Acid
A substance that results from the breakdown of purines, which are part of all human tissue and are found in many foods.

More about Gout

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See Also: Arthritis

Other terms to know: See all 6
Chondrocalcinosis (Pseudogout), Hyperuricemia, Podagra

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