[Gout, beyond the joint: How should we treat it?]

Semergen. 2024 Jul-Aug;50(5):102176. doi: 10.1016/j.semerg.2023.102176. Epub 2024 Feb 1.
[Article in Spanish]

Abstract

Gout is a disease caused by the chronic deposition of monosodium urate crystals. Its clinical presentation as an acute, self-limiting arthritis and the belief that it is a banal, self-inflicted disease have led to its poor management. Despite advances in the knowledge of the disease and the simplicity of its management, no more than 30% of patients are well treated. In Spain, the prevalence of gout is 2.5% and its incidence is increasing. In the following article we will review the pathogenesis of gout and hyperuricaemia, highlighting the greater weight of genetics and renal function over diet. We will look at the consequences of crystal deposition. Gout, in addition to its joint presentation and renal involvement, has been shown to be an independent cardiovascular risk factor. Hypouricemic therapy is the most important treatment, as it is the one that dissolves the crystals and cures the disease. This requires the sustained achievement of uricemia levels below 6mg/dl. We will also review preventive and flares treatment, as well as the role of patient education in terms of both lifestyle and dietary habits and adherence to pharmacological treatment.

Keywords: Allopurinol; Alopurinol; Atención primaria; Febuxostat; Gota; Gout; Hiperuricemia; Hyperuricemia; Primary health care; Uric acid; Ácido úrico.

Publication types

  • Review
  • English Abstract

MeSH terms

  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control
  • Cardiovascular Diseases / therapy
  • Diet
  • Gout Suppressants / therapeutic use
  • Gout* / diagnosis
  • Gout* / therapy
  • Humans
  • Hyperuricemia* / diagnosis
  • Hyperuricemia* / etiology
  • Hyperuricemia* / therapy
  • Incidence
  • Life Style
  • Medication Adherence
  • Patient Education as Topic
  • Prevalence
  • Risk Factors
  • Spain
  • Uric Acid / blood
  • Uric Acid / metabolism

Substances

  • Uric Acid
  • Gout Suppressants