Professional Documents
Culture Documents
doi:10.1093/rheumatology/kem056a
KEY
WORDS:
The aim has been to develop concise, patient-focussed, evidencebased recommendations for the management of gout for doctors
and allied heath professionals in primary care and hospital
practice in the UK, which will also provide a useful resource for
patients.
Recommendations for the diagnosis and investigation of gout
[8] are not addressed.
1372
The Author 2007. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Kelsey M. Jordan, J. Stewart Cameron1, Michael Snaith2, Weiya Zhang3, Michael Doherty3,
Jonathan Seckl4, Aroon Hingorani5, Richard Jaques6, George Nuki7 on behalf of the British Society for
Rheumatology and British Health Professionals in Rheumatology Standards, Guidelines and Audit
Working Group (SGAWG)
1373
Review at 46 weeks
Assess lifestyle factors, blood pressure
& perform serum urate, renal function
& glucose in all patients
Resolution
All patients
Optimize weight
Increase exercise
Modify diet
Reduce alcohol
intake
Maintain fluid intake
Treat underlying
cardiovascular risk
factors
No renal impairment
Change to
Sulphinpyrazone
or
Benzbromarone
or
Probenecid
Consider combination therapy
Renal impairment
Change to
Benzbromarone
Consider combination therapy
with low dose allopurinol
1374
K. M. Jordan et al.
References
1 Mikuls TR, Farrar JT, Bilker WB, Fernandes S, Schumacher HR Jr, Saag KG. Gout
epidemiology: results from the UK general practice research database,1990-1999.
Ann Rheum Dis 2005;64:26772.
2 Schumacher HR Jr, Boice JA, Daikh DI et al. Randomised double blind trial of
etoricoxib and indometacin in treatment of acute gouty arthritis. Brit Med J
2002;324:148892.
3 Vogt B. Urate oxidase (rasburicase) for treatment of severe tophaceous gout.
Nephrol Dial Transplant 2005;20:4313.
4 Becker MA, Schumacher HR Jr, Wortmann RL et al. Febuxostat, a novel
nonpurine selective inhibitor of xanthine oxidase: a twenty-eight-day, multicenter,
phase II, randomized, double-blind, placebo-controlled, dose-response clinical
trial examining safety and efficacy in patients with gout. Arthritis Rheum
2005;52:91623.
5 Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Alcohol intake and risk of
incident gout in men: a prospective study. Lancet 2004;363:127781.
6 Choi HK, Atkinson K, Karlson EW, Willett W, Curhan G. Purine-rich foods, dairy and
protein intake, and the risk of gout in men. N Eng J Med 2004;350:1093103.
7 Rigby NJ, Kumanyika S, James WP. Confronting the epidemic: the need for global
solutions. J Public Health Policy 2004;25:41834.
8 Zhang W, Doherty M, Pascual-Gomez E et al. EULAR evidence-based recommendations for gout. Part 1: Diagnosis. Ann Rheum Dis 2006;65:130111.
9 http://www.rcplondon.ac.uk/college/ceeu/conciseGuidelineDevelopmentNotes.pdf