Gout and Hyperuricemia: New Guidelines and Treatments

Gout is the most common inflammatory arthritis in western countries and the incidence is increasing. Additionally, evidence now exists that cases of severe, refractory gout seem to be increasing. The manage-ment of gout and hyperuricemia has remained largely unchanged for decades and includes antiinflamma-tories used initially for acute attacks and primarily allo-purinol to prevent future attacks. Evidence-based guidance for the management of gout and hyperurice-mia has been plagued by a lack of randomized, con-trolled studies and the lack of new medications. Recently evidence-based guidelines by the European League Against Rheumatism were published; one of the first attempts by a major medical body to assess the state of gout and hyperuricemia treatment. Additionally, sev-eral new compounds seem poised to be released for hyperuricemia treatment. This review details the impor-tant aspects of the gout guidelines relating to pharma-cotherapy and critically examines the data surrounding new modalities to decrease serum uric acid