Praktické lekárnictvo 1/2024

Treatment of gout, traditional and new pharmacotherapy use

Gout (arthritis urica) is chronic metabolic multifactor disease as a result of the hyperuricaemia. The disease is purine metabolism disorder. It belongs to treatable rheumatic diseases. Its origin is based on genetic or external factors. Gout’s pathological manifestations are acute and chronic gouty arthritis, tophi formation, kidney impairment and urolithiasis. The asymptomatic hyperuricaemia period comes before acute gouty attack. Hyperuricaemia is the most crucial laboratory finding. In treatment management of gout there are used nonpharmacological measures and pharmacotherapy. To nonpharmacological measures there belong low purine diet and lifestyle modifications. Pharmacotherapy of gout is as follows: anti-inflammatory drugs (non-steroidal anti-inflammatory drugs (NSAIDs), colchicine, monoclonal antibodies, glucocorticoids) and hyperuricaemia decreasing drugs (uricostatics, uricosuric agents, uricases). Uricosuric agents are not being presently used in the Slovak Republic just as in the Czech Republic, pegloticase is not being registered in the European Union at the moment. Colchicine and NSAIDs are first choice medicine for inflammation and pain reduction and allopurinol for hyperuricaemia reduction. Febuxostat is second choice medicine for hyperuricaemia reduction. Monoclonal antibodies and uricases as a new treatment management are second choice medicine. Second choice medicine is recommended for the patients with traditional pharmacotherapy intolerance or suffering from severe polyarticular gout.

Keywords: gout, hyperuricaemia, arthritis urica, treatment of gout, pharmacotherapy of gout