![]() ![]() ![]() An acute attack often begins to remit after 5 to 12 days without intervention, but complete resolution may take longer in some patients. This article briefly reviews the relevant ACR recommendations and details important comorbidity and concomitant medication considerations in the treatment of acute gout.Īcute gout attacks are characterized by a rapid onset and escalation with joint pain typically peaking within 24 hours of attack onset. 3 The ACR recommends 3 first-line therapies, but limited guidance is provided for deciding among therapies. Recently, the American College of Rheumatology (ACR) released management recommendations for gout, including those for the treatment of acute gout. 2 Because the VA patient population tends to be older, acute gout and attendant complications of treatment are an important consideration for VA health care providers (HCPs). Patients with gout tend to be older and have multiple comorbidities that require the use of many medications. Alleviating the pain and inflammation of an acute attack is often complicated by patient characteristics, namely, other chronic health conditions that frequently accompany gout, such as diabetes mellitus (DM), chronic kidney disease (CKD), hypertension, and cardiovascular disease (CVD). Gout treatment has 2 overarching goals: alleviating the pain and inflammation caused by acute gout attacks and long-term management that is focused on lowering serum urate (sUA) levels to reduce the risk of future attacks. Nearly 10% of those aged > 65 years report having gout. ![]() Over time, gout can lead to chronic pain, disability, and tophi. As a result, gout is characterized by painful arthritis flares followed by intervening periods of disease quiescence. Gout is an extremely painful arthritis initiated by innate immune responses to monosodium urate crystals that accumulate in affected joints and surrounding tissues. ![]()
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