Rheumatology Division, Hospital Universitario Cruces, Pza Cruces, Baracaldo, Vizcaya, Spain.
Adv Ther. 2012 Nov;29(11):935-46. doi: 10.1007/s12325-012-0059-z. Epub 2012 Oct 25.
Gout is a disease caused by deposition of monosodium urate crystals in tissues. One of the limitations for successful treatment of gout is to consider it as an intermittent disease rather than a chronic inflammatory disease which, if improperly treated, leads to chronic clinical manifestations. In addition, gout is linked to increased cardiovascular morbidity and mortality.Urate-lowering therapy comprises both nonpharmacologic and pharmacologic interventions, but most patients will need urate-lowering drugs to achieve target therapeutic serum urate levels. Reaching target serum urate levels is associated with improvement in clinical outcomes, including a reduction of acute inflammation episodes, resolution of tophi, and improvement in health-related quality of life perception.A number of urate-lowering drugs are available but a number of patients fail to achieve or maintain therapeutic serum urate levels and go on to develop refractory chronic gout. For such patients, efforts have been made to develop new treatments (e.g., febuxostat or pegloticase).This review intends to increase the awareness of gout as a chronic deposition disease, and show that efforts should be made to properly control serum urate levels in order to achieve complete disappearance of urate crystal deposition.
痛风是一种由单钠尿酸盐晶体在组织中沉积引起的疾病。成功治疗痛风的一个局限性是将其视为间歇性疾病，而不是慢性炎症性疾病，如果治疗不当，会导致慢性临床表现。此外，痛风与心血管发病率和死亡率的增加有关。降低尿酸治疗包括非药物和药物干预，但大多数患者需要降低尿酸药物来达到目标治疗血清尿酸水平。达到目标血清尿酸水平与改善临床结局相关，包括减少急性炎症发作、解决痛风石和改善健康相关生活质量感知。有多种降低尿酸的药物可供选择，但许多患者无法达到或维持治疗性血清尿酸水平，并继续发展为难治性慢性痛风。对于这些患者，已经努力开发新的治疗方法（例如，非布司他或培戈洛酶）。本综述旨在提高对痛风作为一种慢性沉积疾病的认识，并表明应努力适当控制血清尿酸水平，以实现尿酸晶体沉积的完全消失。
