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The main aim of treatment in gout is to control symptoms of an acute attack, risk factor modification and pharmacotherapy to prevent recurrences and chronic episodes (1)

Optimal treatment of gout should include both nonpharmacologic and pharmacologic modalities and should be modified according to the following: (2)

  • specific risk factors - SUA levels, previous attacks, radiographic signs
  • clinical phase - acute gout, intercritical gout, or chronic tophaceous gout
  • general risk factors - age, sex, obesity, diet, alcohol consumption, urate-elevating drugs, drug interactions, renal function, (2).

Prophylactic allopurinol and uricosurics:

  • are used for chronic gout only
  • are not effective in acute attack
  • are not used in an acute attack because they may prolong it indefinitely


Last reviewed 09/2020