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Acute Gout, Hyperuricemia- urate lowering therapies, Recurrent Acute Gouty…
Acute Gout
Corticosteroids
Glucocorticoids
ACTH
Anti-inflammatory/ Anti-mitotic
Colchicene
inhibition of neutrophil phagocytosis/mitosis
NSAIDs
prostaglandin inhibitors
Hyperuricemia- urate lowering therapies
Urate oxidase recombinant
Converts uric acid --> Allantoin
Pegloticase
Short term prophylaxis against acute gouty attack
Use whenever starting any urate lowering therapy!
Colchicene
Corticosteroids
NSAIDs
Xanthine oxidase inhibitors
Febuxostat (non-purine analog)
Allopurinol (purine analog)
Uricosuric
Block renal tubular reabsorption
Probenecid (weak acid nonselective)
Lesinurad (urate selective)
Recurrent Acute Gouty Arthritis
Urate lowering therapy
Acute gout prophylaxis
1st line = low dose colchicene or NSAIDs
2nd line = low dose corticosteroids
Chronic Gouty Arthritis
NSAIDs/ acute gout prophylaxis
low or high dose NSAIDs, low dose colchicine or corticosteroids
+/- Urate lowering drugs
Tophaceous Gout
Urate lowering therapy
Peglitocase if severe
Short-term acute gout prophylaxis