![]() ![]() The colchicine is continued at 0.6 mg daily or twice daily until symptoms are resolved. In absence of renal impairment, the loading dose is 1.2 mg orally, followed by 0.6 mg one hour later. Guidelines emphasize that oral colchicine is particularly efficacious when started within the first 36 hours of the attack. In the setting of acute gouty arthritis, monotherapy with NSAIDs (Naproxen, and Indomethacin), Colchicine, or systemic corticosteroids is recommended, particularly if involving one or a few small joints. The rising rate has been attributed to the concomitant rise in comorbidities including hypertension, obesity, type 2 diabetes and chronic kidney disease. In this article, we will specifically address the data supporting management of acute and chronic gout.ĭata that answers these questions or gaps:Īs per American College of Rheumatology (2012) guidelines for the management of gout, the self-reported prevalence of gout in adults is almost 4% (8.3 million people) in the United States. We covered the diagnosis of gout in the acute setting in a previous “This Changed My Practice” article ( ). I have noticed primary care providers are hesitant to initiate allopurinol or titrate to an optimal dose, especially in patients with chronic kidney disease. ![]() What care gaps/frequently asked questions I have noticed:ĭespite being one of the most common forms of arthritis afflicting adults, optimal care of patients with gout including treatment of acute attacks as well as long-term management is not always achieved. Treatments or recommendations in this article are unrelated to products/services/treatments involved in disclosure statements.Recommendations are consistent with current practice patterns.Recommendations are consistent with published guidelines.Has been involved with: Augurex, Pfizer, UCB, Abbvie, Janssen, Roche, and Celgene. Part 1: Diagnosing Gout in Primary Care Settings: Do we have to tap? By Neda Amiri, MD, FRCPC, PGY5 ( biography and disclosures) Kam Shojania, MD, FRCPC ( biography and disclosures)
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