Table 1 |
|
Common features of 'treatment-refractory' gout that complicate management |
| Polyarticular gout, uncontrolled flare activity, and/or chronic synovitis |
| Destructive tophi |
| Advanced age |
| Co-morbidities (for example, chronic kidney disease, cardiovascular disease, obesity,
metabolic syndrome or diabetes, alcohol abuse) |
| Polypharmacy and drug interactions (for example, statins, macrolide antibiotics, oral
anticoagulants) |
| Contra-indications or refractoriness to NSAIDs, colchicines, and/or glucocorticosteroids |
| Allopurinol intolerance or hypersensitivity and inability to employ uricosurics |
| Failure to adequately lower serum urate on appropriate doses of urate-lowering drugs |
|
|
|
NSAID, nonsteroidal anti-inflammatory drug. |
|
Terkeltaub Arthritis Research & Therapy 2009 11:236 doi:10.1186/ar2738 |