Run the List Gout: Acute and Long-Term Management
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Mar 26, 2025 Dr. Michael Pillinger, an expert in gout management and treatment strategies, shares his insights on acute and long-term care for gout sufferers. He delves into the critical role of lifestyle changes and triggers that can provoke painful flare-ups. The conversation highlights the importance of urate-lowering therapies and how medications like allopurinol and newer treatments, such as peglodicase, can make a difference. Pillinger also discusses personalized treatment plans and the need for careful dosing, especially in patients with kidney issues.
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Acute Gout Flare Treatment
- Treat acute gout flares with NSAIDs (at higher doses), glucocorticoids (oral prednisone or intra-articular injections), or colchicine.
- Consider IL-1 inhibitors for severe cases, often involving rheumatology consultation.
Gout as a Metabolic Condition
- Gout is a chronic metabolic condition, not just occasional toe pain.
- Treat the underlying metabolic issue, not just the acute flares, for long-term management.
Urate-Lowering Therapy
- Treat gout with urate-lowering therapy if flares are recurrent, especially with high urate levels or kidney disease.
- Target serum uric acid levels below 6.0 mg/dL to prevent new crystal formation.