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Highly Accessed Review

Gout. Novel therapies for treatment of gout and hyperuricemia

Robert Terkeltaub

Author Affiliations

Rheumatology Section, San Diego Veterans Affairs Medical Center, and University of California San Diego School of Medicine, VA Medical Center, 3350 La Jolla Village Drive, San Diego, CA 92161, USA

Arthritis Research & Therapy 2009, 11:236  doi:10.1186/ar2738

Published: 23 July 2009

Abstract

In the past few decades, gout has increased not only in prevalence, but also in clinical complexity, the latter accentuated in part by a dearth of novel advances in treatments for hyperuricemia and gouty arthritis. Fortunately, recent research reviewed here, much of it founded on elegant translational studies of the past decade, highlights how gout can be better managed with cost-effective, well-established therapies. In addition, the advent of both new urate-lowering and anti-inflammatory drugs, also reviewed here, promises for improved management of refractory gout, including in subjects with co-morbidities such as chronic kidney disease. Effectively delivering improved management of hyperuricemia and gout will require a frame shift in practice patterns, including increased recognition of the implications of refractory disease and frequent noncompliance of patients with gout, and understanding the evidence basis for therapeutic targets in serum urate-lowering and gouty inflammation.