Peter Gavorník, Andrej Dukát, Ľudovít Gašpar
Gout is an metabolically, inflammatory conditioned crystal-induced disease. Prevalence of gout is on the increase. In
clinical practice it is frequently wrongly diagnosed and the management of acute attacks in particular is not adequate.
First of all the advantage of the analysis of synovial liquid and of direct evidence of crystals in polarization microscope
is emphasised. In the therapy of acute gouty attack its early start is more important than the choice of a preparation.
Alternatives are colchicine, NSA or glucocorticoids. A newly registered medicine for the therapy of refractory acute inflammation
is the IL-1 inhibitor canakinumab. The management of hyperuricemia involves regimen and diet measures,
abstinence and antihyperuricemic pharmacotherapy. Available are the xanthine oxidase inhibitors, allopurinol and febuxostat.
A new medicine for therapy of severe refractory tophaceous gout is pegloticase.