The safety of treatment options available for gout

Expert Opin Drug Saf. 2017 Apr;16(4):429-436. doi: 10.1080/14740338.2017.1284199. Epub 2017 Jan 30.

Abstract

Gout is the most common inflammatory arthritis in humans. Gout treatment includes rapid initiation of anti-inflammatory medications for acute attacks and chronically treating with urate lowering drugs as well as chronic anti-inflammatory prophylaxis. Areas covered: This review aims to provide an overview and discussion of the safety concerns of current treatment options available for gout. Expert opinion: Gout is a curable disease with appropriate treatment. The advent of new therapies provides encouraging opportunities to improve gout management. However, clinicians should be aware of some of the safety concerns of medications used to treat acute and chronic gout. When prescribing medications for gout one has to be mindful of the presence of comorbidities commonly affecting gout patients that may affect drug safety and efficacy, especially in the elderly and in patients treated with multiple drugs. The benefits of gout drugs, usually, outweigh their safety concerns. Studies are needed in gout patients with chronic kidney disease and/or cardiovascular disease, so that escalation of dosing /combination of anti-inflammatory drugs needed to suppress gouty inflammation as well as escalation of dosing/combination of urate lowering drugs needed to achieve target serum urate level will lead to better understanding of gout treatment safety issues.

Keywords: Safety; acute gout; anti-inflammatory drugs; chronic gout; urate lowering drugs; uric acid.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Aged
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / therapeutic use*
  • Chronic Disease
  • Comorbidity
  • Gout / drug therapy*
  • Gout / physiopathology
  • Gout Suppressants / administration & dosage
  • Gout Suppressants / adverse effects
  • Gout Suppressants / therapeutic use*
  • Humans
  • Uric Acid / metabolism

Substances

  • Anti-Inflammatory Agents
  • Gout Suppressants
  • Uric Acid