Key Points
` Gout is one of the most common rheumatic diseases of adulthood, with a
self-reported prevalence in the US recently estimated at 3.9% of adults
(~8.3 million people).
` Hyperuricemia leads to the formation and deposition of uric acid crystals,
which leads to the clinical symptoms of gout.
` Gout is manifested by either acute attacks of inflammatory arthritis or
clinical deposition of uric acid crystals in joints, tendons, bursas or other
tissues (known as tophi).
` The increasing prevalence of gout is mediated by factors such as an
increased incidence of comorbidities that promote hyperuricemia, including
hypertension, obesity, metabolic syndrome, and chronic kidney disease,
certain dietary trends, and widespread prescriptions of thiazide and loop
diuretics for cardiovascular diseases.
` Indications for treating chronic gout and hyperuricemia include frequent
attacks, clinical tophi, concurrent chronic kidney disease, or history of
kidney stones.
` Initiation of urate lowering therapy should be accompanied by prophylactic
anti-inflammatory treatment to avoid the transient increased risk of acute
gout attacks with the initiation of urate lowering therapy.
