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Gout: can management be improved?

Schlesinger, Naomi MD*; Schumacher, H. Ralph Jr. MD

Current Opinion in Rheumatology: May 2001 - Volume 13 - Issue 3 - p 240-244
Crystal deposition diseases

Ongoing reviews of Cochrane collaboration show that there is still very little reliable information based on randomized controlled trials on which to base treatment decisions in acute and chronic gout. Recent studies have stressed that avoidance of factors contributing to development of gouty attacks such as diuretic therapy, weight gain, and alcohol consumption may lead to a decrease in gouty arthritis. Attention to minidose aspirin and its effect on serum uric acid levels was addressed. A low carbohydrate, high protein and unsaturated fat diet was recommended for gouty patients since they all enhance insulin sensitivity and therefore may promote a reduction in serum uric acid levels. Treatment of gout in transplant recipients brings into focus some of the issues regarding management of gout, because gout is a common problem among transplant patients.

*Section of Rheumatology, UMDNJ/New Jersey Medical School, Newark, New Jersey; and Division of Rheumatology, University of Pennsylvania School of Medicine, and the Department of Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.

Correspondence to Naomi Schlesinger, MD, Rheumatology Section, UMD-NJ Medical School, Department of Medicine, 185 S. Orange Ave., MSB 1-506, Newark, NJ 07103-2714, USA; e-mail: schlesna@umdnj.edu

© 2001 Lippincott Williams & Wilkins, Inc.