Managementul farmacologic al gutei – între clasic şi modern

Gout is a common and complex form of arthritis, characterized by sudden attacks, pain, swelling, redness and tenderness of the joints. The main causes of gout are relatively high levels of uric acid in the blood and the deposition of crystals at the joint level. These may occur due to an improper diet, a genetic predisposition or a sub-excretion of the uric acid salts (urates). The management of gout is complex, involving special diet, therapy of acute attacks and prevention of recurrences. Complementary and alternative methods (relaxation techniques, meditation and psychotherapy) can be used as adjunct elements to pharmacological therapy. The medication of acute gout attack is represented by colchicine and the non-steroidal antiinflammatory drugs. The chronic gout treatment consists in the administration of xanthine oxidase inhibitors (allopurinol) and uricosuric agents (probenecid, oxaprozin, sulfinpyrazone). New pharmacological active agents, such as febuxostat (selective inhibitor of non-purine xanthine oxidase), lesinurad (selective inhibitor of the uric acid URAT1 transporter in the kidney), rasburicase (recombinant urate oxidase) and pegloticaze (recombinant uricase), have been recently introduced in the therapy of gout.