Current Management Concepts in Gouty Arthritis

BackgroundGouty arthritis is an extremely painful condition that causes functional impairment. Longstanding elevation of the serum uric acid level can lead to the deposition of monosodium urate crystals, causing gout (arthritis, urate nephropathy, tophi). Gouty arthritis has become increasingly complex because of multiple comorbidities, iatrogenic factors and hyperuricemia that is refractory to treatment. In this review, we present a general overview of gouty arthritis including its pathophysiology, clinical presentations, diagnosis, management and emerging therapies to treat gouty arthritis and flares. Materials and Methods: Selective literature review on the diagnosis and treatment of gout. Results & Conclusion: Asymptomatic hyperuricemia is generally not an indication for pharmacological intervention to lower the uric acid level. When gout is clinically manifest, however, acute treatment of gouty arthritis should be followed by determination of the cause of hyperuricemia, and long-term treatment to lower the uric acid level is usually necessary. The goal of treatment is to diminish the body's stores of uric acid crystal deposits and thereby to prevent the inflammatory processes that they cause, which lead to structural alterations. The available medications for this purpose are allopurinol and various uricosuric agents, e.g., benzbromarone. There is good evidence to support the treatment of gouty attacks by the timely, short-term use of non-steroidal anti-inflammatory drugs , colchicine, and glucocorticosteroids. Additional newer drugs such as IL-1 inhibitors have been developed to improve the management