Dnavá artritida - současné možnosti farmakoterapie

Title in English Gout - current pharmacotherapy


Year of publication 2015
Type Article in Periodical
Magazine / Source Remedia
MU Faculty or unit

Faculty of Medicine

Field Other specializations of internal medicine
Keywords gout; hyperuricemia; uric acid; allopurinol; febuxostat; colchicine; pegloticase; canakinumab
Description Gout is a heterogeneous group of metabolic diseases which is characterized by the formation and deposition of sodium urate crystals in various tissues. Hyperuricemia is a pathological increase in serum uric acid concentration. Gout affects approximately 1-2% of adults in developed countries, and its prevalence is increasing in recent decades. Despite knowledge of the pathogenesis and clinical manifestation of the disease, gout is often not diagnosed correctly and early, treatment is not well managed, which can result in damage of the joint structure, leading to decline in physical abilities and deterioration in the quality of life of patients. Hyperuricemia is a major independent risk factor for development of gout. Acute gout attack may be an early manifestation of gout. Chronic tophaceous gout indicates the state when the structures of the musculoskeletal system are destructed by the deposition of sodium urate crystals. The reduction and long-term maintenance of serum uric acid concentrations below 360 umol/l is a necessary prerequisite of successful treatment of gout which allows the dissolution of urate deposits in tissues and prevents their formation. The article deals with current treatment options at each stage of the gout, treatment of asymptomatic hyperuricemia, acute gout attack, intercritical period, and chronic tophaceous gout. Prophylactic treatment of gout flares is also an essential part of the treatment of symptomatic hyperuricemia. New treatment options of hyperuricemia and acute gout attack with pegylated uricase and IL-1beta inhibitor canakinumab are also mentioned. The text is based on current national and international guidelines for the treatment of hyperuricemia and gout.

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