What is The First line Drug of Choice for Treating Gout

Improving the care of patients with gout is an important national health priority. Gouty arthritis is an important quality of life and economic issue. In the United States, there are an estimated 8.3 million patients with gout, a 3.9% prevalence. The costs of gout to society are high. Multiple studies reflect the effect of gout on quality of life and its association with an increased mortality.5 Although the hospitalization rate has been dropping in patients with rheumatoid arthritis, it is increasing in gout. Gout is associated with kidney stones, and travels with many comorbidities.

Many reasons have been postulated for this failure, including patient misconceptions, nonadherence to medication,and comorbidities crowding out time for gout discussion at physician visits.Therapy for gout is effective, yet most patients with gout do not reach their urate goal. Urate-lowering medication is The First line Drug of Choice for Treating Gout.

Why do people with gout not take their urate-lowering medication?
• They feel better between flares and stop treatment
• They do not understand that gout is “still there” between episodes
• They do not believe that they can become “gout-free” if they stay with the medication; they often think that having gout flares is part of the immutable long-term picture
• They have many comorbidities and thus many medications, and do not want more
• They think diet is the answer, but they just have not done it well enough; they think it is “their fault,” even after being educated about gout’s genetic basis
• Mobilization flares when starting urate-lowering therapy make them lose confidence in treatment effectiveness, and they abandon urate-lowering therapy

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