Pub Date : 2020-02-26DOI: 10.5772/intechopen.86253
R. Kurose
Gout is a disease known since before the Common Era. There are reports of urate crystal deposition in the big toe joints of an excavated mummy in ancient Egypt. There are records of many figures throughout Western history who experienced the painful suffering of gout, for example, Alexander the Great of Macedonia, King Carlos V of Spain, Frederick the Great of Prussia, Louis XIV of France, Martin Luther of the Reformation, Oliver Cromwell of the Puritan Revolution, the artist Michelangelo, Leonardo da Vinci, the poets Dante and Milton, the physicist Isaac Newton, and the biologist Charles Darwin, among others. In contrast, there is little historical evidence of gout in Asia. Yet the disease has become common in modern society [1–3]. The prevalence of gout in the past has generally been higher among middle-aged men, but in recent years, the number of young people and women with gout has been increasing.
{"title":"Introductory Chapter: Gout","authors":"R. Kurose","doi":"10.5772/intechopen.86253","DOIUrl":"https://doi.org/10.5772/intechopen.86253","url":null,"abstract":"Gout is a disease known since before the Common Era. There are reports of urate crystal deposition in the big toe joints of an excavated mummy in ancient Egypt. There are records of many figures throughout Western history who experienced the painful suffering of gout, for example, Alexander the Great of Macedonia, King Carlos V of Spain, Frederick the Great of Prussia, Louis XIV of France, Martin Luther of the Reformation, Oliver Cromwell of the Puritan Revolution, the artist Michelangelo, Leonardo da Vinci, the poets Dante and Milton, the physicist Isaac Newton, and the biologist Charles Darwin, among others. In contrast, there is little historical evidence of gout in Asia. Yet the disease has become common in modern society [1–3]. The prevalence of gout in the past has generally been higher among middle-aged men, but in recent years, the number of young people and women with gout has been increasing.","PeriodicalId":344497,"journal":{"name":"Recent Advances in Gout","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133698655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-05DOI: 10.5772/INTECHOPEN.85717
R. Sahai, P. Sharma, A. Misra, S. Dutta
Gout is a metabolic disorder characterized by hyperuricemia. Asymptomatic hyperuricemia ought not to be treated until arthritis; renal calculi or tophi become evident. The cornerstone of therapy of acute attack is often nonsteroidal anti-inflammatory drugs (NSAIDs), barring specific situations wherein colchicine and corticosteroids do have a role. Usually NSAIDs with stronger anti-inflammatory action are used in high and quickly repeated doses and have a slower response response as compared to colchicine, they are better tolerated. Colchicine has a unique mechanism action. Intra-articular corticosteroids provide relief in acute attack and are given in patients having inability to tolerate NSAIDs and colchicine. Chronic gout requires treatments with drugs that either promote excretion (e.g., probenecid, lesinurad) or prevent its synthesis through inhibition of enzyme xanthine oxidase (allopurinol, febuxostat, etc.). Pegloticase and rasburicase, being a recombinant uricase enzyme, oxidize uric acid to highly soluble allantoin excreted in urine. In spite of these effective treatment modali-ties, question arises on their safety profile. Newer treatment options are being extensively studied especially interleukin-1 (IL-1) inhibitors but their approval is still pending. The quest for an optimally designed drug with desirable efficacy and acceptable safety profile is still on.
{"title":"Pharmacology of the Therapeutic Approaches of Gout","authors":"R. Sahai, P. Sharma, A. Misra, S. Dutta","doi":"10.5772/INTECHOPEN.85717","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85717","url":null,"abstract":"Gout is a metabolic disorder characterized by hyperuricemia. Asymptomatic hyperuricemia ought not to be treated until arthritis; renal calculi or tophi become evident. The cornerstone of therapy of acute attack is often nonsteroidal anti-inflammatory drugs (NSAIDs), barring specific situations wherein colchicine and corticosteroids do have a role. Usually NSAIDs with stronger anti-inflammatory action are used in high and quickly repeated doses and have a slower response response as compared to colchicine, they are better tolerated. Colchicine has a unique mechanism action. Intra-articular corticosteroids provide relief in acute attack and are given in patients having inability to tolerate NSAIDs and colchicine. Chronic gout requires treatments with drugs that either promote excretion (e.g., probenecid, lesinurad) or prevent its synthesis through inhibition of enzyme xanthine oxidase (allopurinol, febuxostat, etc.). Pegloticase and rasburicase, being a recombinant uricase enzyme, oxidize uric acid to highly soluble allantoin excreted in urine. In spite of these effective treatment modali-ties, question arises on their safety profile. Newer treatment options are being extensively studied especially interleukin-1 (IL-1) inhibitors but their approval is still pending. The quest for an optimally designed drug with desirable efficacy and acceptable safety profile is still on.","PeriodicalId":344497,"journal":{"name":"Recent Advances in Gout","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129770299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-20DOI: 10.5772/INTECHOPEN.85030
Dewen Yan, Youming Zhang
Gout is a common and complex form of arthritis that is characterized with hyperuricaemia. It is required urate-lowering therapy (ULT) for lifelong management. ULT includes decreasing uric acid product in serum, increasing renal urate excretion and promoting uric acid to allantoin for excretion. Whole genome association studies in gout identified more than 40 genetic loci that influenced the serum uric acid levels. Most associated genes were found to affect renal urate excretion. Pharmacogenetics and pharmacogenomics approaches on ULT had revealed several genes that underlined the effectiveness and the adverse events of medications for gout. Together with the researches on epigenetic factors such as DNA methylations, miRNAs; and the discovery of environmental factors such as microbiota and metabolites, the current progress provides the opportunities for personalized management of ULT for treating hyperuricaemia and gout.
{"title":"Personalized Medicine of Urate-Lowering Therapy for Gout","authors":"Dewen Yan, Youming Zhang","doi":"10.5772/INTECHOPEN.85030","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.85030","url":null,"abstract":"Gout is a common and complex form of arthritis that is characterized with hyperuricaemia. It is required urate-lowering therapy (ULT) for lifelong management. ULT includes decreasing uric acid product in serum, increasing renal urate excretion and promoting uric acid to allantoin for excretion. Whole genome association studies in gout identified more than 40 genetic loci that influenced the serum uric acid levels. Most associated genes were found to affect renal urate excretion. Pharmacogenetics and pharmacogenomics approaches on ULT had revealed several genes that underlined the effectiveness and the adverse events of medications for gout. Together with the researches on epigenetic factors such as DNA methylations, miRNAs; and the discovery of environmental factors such as microbiota and metabolites, the current progress provides the opportunities for personalized management of ULT for treating hyperuricaemia and gout.","PeriodicalId":344497,"journal":{"name":"Recent Advances in Gout","volume":"74 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115071401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-02-15DOI: 10.5772/INTECHOPEN.84456
Eliseev Ms, M. Chikina, Nasonov El
During the first months after the initiation of urate-lowering therapy in gout patients, the risk of exacerbation of arthritis considerably rises, which often results in discontinuation of the prescribed therapy by patients. The main way to avoid this risk is preventive prescription of colchicine, NSAIDs or glucocorticoids. Such prophylaxis of acute arthritis has been specified in a large number of the latest editions of various national and international guidelines; however, this tactics is rarely used in practice. The chapter includes the most significant studies on this problem.
{"title":"Prophylaxis of Acute Arthritis at Initiation of Urate-Lowering Therapy in Gout Patients","authors":"Eliseev Ms, M. Chikina, Nasonov El","doi":"10.5772/INTECHOPEN.84456","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.84456","url":null,"abstract":"During the first months after the initiation of urate-lowering therapy in gout patients, the risk of exacerbation of arthritis considerably rises, which often results in discontinuation of the prescribed therapy by patients. The main way to avoid this risk is preventive prescription of colchicine, NSAIDs or glucocorticoids. Such prophylaxis of acute arthritis has been specified in a large number of the latest editions of various national and international guidelines; however, this tactics is rarely used in practice. The chapter includes the most significant studies on this problem.","PeriodicalId":344497,"journal":{"name":"Recent Advances in Gout","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126291080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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