Management of complex gout in clinical practice: Update on therapeutic approaches.

Show simple item record Narang, Ravi K en Dalbeth, Nicola en 2019-06-14T02:10:58Z en 2018-12 en
dc.identifier.issn 1521-6942 en
dc.identifier.uri en
dc.description.abstract Increasing therapeutic options are available for gout management. Anti-inflammatory agents are used in the acute management of gout flares, and interleukin-1 inhibitors are effective for those unable to take conventional anti-inflammatory treatments. Lowering of serum urate remains the cornerstone of effective long-term management. Allopurinol is the first-line urate-lowering therapy, and a gradual dose-escalation strategy to serum urate target is recommended. Febuxostat and lesinurad have been approved more recently. In a large cardiovascular outcomes trial, higher all-cause and cardiovascular mortality was observed with febuxostat than with allopurinol. Lesinurad should be co-prescribed with a xanthine oxidase inhibitor, and close monitoring of kidney function is required. Evidence for non-pharmacological management is limited, but personalised lifestyle modification may reduce associated cardiovascular risk. In this review, we discuss current principles in the gout management paradigm, consider strategies for managing complex, clinical scenarios, and review emerging therapies. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Best practice & research. Clinical rheumatology en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri en
dc.subject Humans en
dc.subject Gout en
dc.subject Gout Suppressants en
dc.subject Febuxostat en
dc.title Management of complex gout in clinical practice: Update on therapeutic approaches. en
dc.type Journal Article en
dc.identifier.doi 10.1016/j.berh.2019.03.010 en
pubs.issue 6 en
pubs.begin-page 813 en
pubs.volume 32 en
dc.rights.holder Copyright: The author en
pubs.end-page 834 en
pubs.publication-status Published en
dc.rights.accessrights en
pubs.subtype Research Support, Non-U.S. Gov't en
pubs.subtype Review en
pubs.subtype Journal Article en
pubs.elements-id 769316 en Medical and Health Sciences en School of Medicine en Medicine Department en
dc.identifier.eissn 1532-1770 en
pubs.record-created-at-source-date 2019-08-21 en
pubs.dimensions-id 31427057 en

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