Department of Rheumatology, City Hospital, Nottingham, UK.
Ann Rheum Dis. 2012 Nov;71(11):1765-70. doi: 10.1136/annrheumdis-2012-201687. Epub 2012 Aug 3.
Gout is the most common inflammatory arthritis and one in which pathogenesis and risk factors are best understood. One of the treatment objectives in current guidelines is 'cure'. However, audits show that only a minority of patients with gout receive adequate advice and treatment. Suboptimal care and outcomes reflect inappropriately negative perceptions of the disease, both in patients and providers. Historically, gout has been portrayed as a benign and even comical condition that is self-inflicted through overeating and alcohol excess. Doctors often focus on managing acute attacks rather than viewing gout as a chronic progressive crystal deposition disease. Urate-lowering treatment is underprescribed and often underdosed. Appropriate education of patients and doctors, catalysed by recent introduction of new urate-lowering treatments after many years with no drug development in the field, may help to overcome these barriers and improve management of this easily diagnosed and curable form of potentially severe arthritis.
痛风是最常见的炎性关节炎，其发病机制和危险因素也最为明确。目前的治疗指南中，有一个治疗目标是“根治”。然而，审计结果显示，只有少数痛风患者接受了充分的建议和治疗。治疗效果欠佳反映出患者和医务人员对该疾病存在负面看法，认为其病情不严重，甚至是一种自找的疾病，是由于暴饮暴食和酗酒导致的。从历史上看，痛风一直被描述为一种良性甚至滑稽的疾病，是由于过度饮食和酗酒引起的。医生通常专注于治疗急性发作，而不是将痛风视为一种慢性进展性晶体沉积疾病。降尿酸治疗的处方不足，且剂量往往不足。近年来，新的降尿酸药物问世，多年来该领域没有新药研发，这可能有助于克服这些障碍，并改善这种易于诊断和可治愈的潜在严重关节炎的管理。
