Rationale:

• Anti-inflammatory agents (nonsteroidal anti-inflammatory drugs or corticosteroids) or colchicine may control the signs and symptoms of an acute gout attack and are the primary treatment of this process.
• Decreasing the uric acid level is helpful in preventing recurrent attacks and other complications of gout.

Evidence:

• Decreasing the uric acid level is necessary to prevent further attacks and control the disease over time. Reduction of serum urate levels to less than 5 mg/dL may be required for resorption of tophi (71).
• A retrospective cross-sectional study has shown that maintaining the uric acid level between 4.6 and 6.6 mg/dL prevents recurrences of gout (54).
• Two reviews discuss the complications of therapy for gout and hyperuricemia (72) and uric acid metabolism (73).
• See section Drug Therapy.
• See table Drug Treatment of Gout.
• See table Commonly Used Nonsteroidal Anti-inflammatory Drugs in Treatment of Acute Gout.

Comments:

• None.