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Báo cáo y học: "Novel therapies for treatment of gout and hyperuricemia"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Novel therapies for treatment of gout and hyperuricemia. | Available online http arthritis-research.eom content 11 4 236 Review Gout Novel therapies for treatment of gout and hyperuricemia Robert Terkeltaub Rheumatology Section San Diego Veterans Affairs Medical Center and University of California San Diego School of Medicine VA Medical Center 3350 La Jolla Village Drive San Diego CA 92161 USA Corresponding author Robert Terkeltaub rterkeltaub@ucsd.edu Published 23 July 2009 This article is online at http arthritis-research.com content 11 4 236 2009 BioMed Central Ltd Arthritis Research Therapy 2009 11 236 doi 10.1186 ar2738 Abstract In the past few decades gout has increased not only in prevalence but also in clinical complexity the latter accentuated in part by a dearth of novel advances in treatments for hyperuricemia and gouty arthritis. Fortunately recent research reviewed here much of it founded on elegant translational studies of the past decade highlights how gout can be better managed with costeffective well-established therapies. In addition the advent of both new urate-lowering and anti-inflammatory drugs also reviewed here promises for improved management of refractory gout including in subjects with co-morbidities such as chronic kidney disease. Effectively delivering improved management of hyperuricemia and gout will require a frame shift in practice patterns including increased recognition of the implications of refractory disease and frequent noncompliance of patients with gout and understanding the evidence basis for therapeutic targets in serum urate-lowering and gouty inflammation. Introduction In the past few decades in the USA and elsewhere gout has markedly increased in incidence and prevalence 1-3 . This includes a marked increase in gout in patients over the age of 65 and even more so in patients over 75 years of age in lockstep with high prevalence of conditions linked with hyperuricemia chronic kidney disease CKD hypertension metabolic syndrome and diabetes and congestive heart failure and rampant