Gout is a disabling and common disease. The prevalence and incidence of the disease have increased steadily in recent years. However, despite effective treatments, gout is still often misdiagnosed and its management remains suboptimal.
Today, our knowledge of the pathophysiology of the disease is improved greatly, and the field of gout management has advanced quickly. When the first guidelines recommendations were produced, the number of drugs available for gout treatment was limited and the main urate-lowering therapy was allopurinol. Since then, a number of new drugs have become available or are in late-stage development (ie, febuxostat, pegloticase, interleukin-1 (IL-1) blockers, lesinurad). Moreover, additional data on established drugs such as colchicine and allopurinol have been published, and studies have repeatedly identified increased cardiovascular mortality with gout.
These are updated recommendations for the diagnosis and management of gout. The role of uric acid (UA) in evolution is, also, discussed. Chapters of UA formation and epidemiology are included.