The epidemiology and treatment of gout

Neil W McGillInstitute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Sydney, AustraliaAbstract: The development and expression of gout depends on three key steps: (1) chronic hyperuricemia, (2) the growth of monosodium urate (MSU) crystals, and (3) interaction between M...

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Autor principal:	McGill NW
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/17e8dfd4921844cb8081341744fbdd84
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spelling	oai:doaj.org-article:17e8dfd4921844cb8081341744fbdd842021-12-02T00:09:31ZThe epidemiology and treatment of gout1179-156Xhttps://doaj.org/article/17e8dfd4921844cb8081341744fbdd842011-12-01T00:00:00Zhttp://www.dovepress.com/the-epidemiology-and-treatment-of-gout-a8926https://doaj.org/toc/1179-156XNeil W McGillInstitute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Sydney, AustraliaAbstract: The development and expression of gout depends on three key steps: (1) chronic hyperuricemia, (2) the growth of monosodium urate (MSU) crystals, and (3) interaction between MSU crystals and the inflammatory system. Epidemiological studies have continued to improve our understanding of the environmental and genetic factors which influence chronic hyperuricemia and gout. The influence of obesity, alcohol, race, sex, age, and specific dietary components will be discussed below. The primary mechanism of hyperuricemia is insufficient renal clearance of uric acid which in turn is dependent on transport of uric acid in the proximal renal tubule. Knowledge of the transport mechanisms has improved understanding of the genetic influences on gout and is relevant to understanding of the effects of drugs which can increase or decrease renal uric acid clearance. The application of established principles of management including diagnosis through crystal identification, the gradual introduction of hypouricemic therapy with the use of prophylaxis to reduce the risk of flares, identification of a suitably low target of plasma urate, a progressive increase in therapy to achieve the target and taking steps to encourage good compliance, has the potential to improve outcomes for patients with this very common affliction. The potential role for new therapies will also be discussed.Keywords: gout, hyperuricemia, allopurinol, febuxostat, lesinurad, pegloticaseMcGill NWDove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2011, Iss default, Pp 73-82 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 McGill NW The epidemiology and treatment of gout
description	Neil W McGillInstitute of Rheumatology and Orthopaedics, Royal Prince Alfred Hospital, Camperdown, Sydney, AustraliaAbstract: The development and expression of gout depends on three key steps: (1) chronic hyperuricemia, (2) the growth of monosodium urate (MSU) crystals, and (3) interaction between MSU crystals and the inflammatory system. Epidemiological studies have continued to improve our understanding of the environmental and genetic factors which influence chronic hyperuricemia and gout. The influence of obesity, alcohol, race, sex, age, and specific dietary components will be discussed below. The primary mechanism of hyperuricemia is insufficient renal clearance of uric acid which in turn is dependent on transport of uric acid in the proximal renal tubule. Knowledge of the transport mechanisms has improved understanding of the genetic influences on gout and is relevant to understanding of the effects of drugs which can increase or decrease renal uric acid clearance. The application of established principles of management including diagnosis through crystal identification, the gradual introduction of hypouricemic therapy with the use of prophylaxis to reduce the risk of flares, identification of a suitably low target of plasma urate, a progressive increase in therapy to achieve the target and taking steps to encourage good compliance, has the potential to improve outcomes for patients with this very common affliction. The potential role for new therapies will also be discussed.Keywords: gout, hyperuricemia, allopurinol, febuxostat, lesinurad, pegloticase
format	article
author	McGill NW
author_facet	McGill NW
author_sort	McGill NW
title	The epidemiology and treatment of gout
title_short	The epidemiology and treatment of gout
title_full	The epidemiology and treatment of gout
title_fullStr	The epidemiology and treatment of gout
title_full_unstemmed	The epidemiology and treatment of gout
title_sort	epidemiology and treatment of gout
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/17e8dfd4921844cb8081341744fbdd84
work_keys_str_mv	AT mcgillnw theepidemiologyandtreatmentofgout AT mcgillnw epidemiologyandtreatmentofgout
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The epidemiology and treatment of gout

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