According to ACP guidelines, high-quality evidence showed no difference between low-dose febuxostat and allopurinol for gout flares. However, febuxostat is associated with higher costs than allopurinol. The most common adverse effect associated with allopurinol is rash. The most common adverse effects associated with febuxostat are abdominal pain, diarrhea, and musculoskeletal pain.
Also according to ACP guidance, low-dose colchicine is recommended when using the medication to treat acute gout. Evidence suggests that lower doses (1.2 mg followed by 0.6 mg 1 hour later) are as effective as higher doses (1.2 mg followed by 0.6 mg/h for 6 hours) for pain management, and are associated with fewer adverse gastrointestinal effects.
The ACP recommends against the use of long-term urate-lowering therapy in most patients after an initial gout attack and in patients with infrequent attacks. Although urate-lowering therapy has shown efficacy in shorter durations, the benefits of long-term use after a single or infrequent gout attacks remain unclear.
The ACP found insufficient evidence to recommend various dietary changes or supplements. Diet modifications alone are rarely able to lower uric acid levels sufficiently to prevent accumulation of urate, although they may help lessen the triggers of acute gout attacks.
This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases article Gout and Pseudogout.
Medscape © 2019 WebMD, LLC
Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.
Cite this: Herbert S. Diamond. Fast Five Quiz: Gout and Pseudogout - Medscape - Dec 04, 2019.