Management overview for gout

The management of gout after a confirmed diagnosis (ideally with crystal-proven disease) is similar for all patients and may include:

starting drug therapy for a patient who presents with acute gout
- see Pharmacological management for acute gout for advice on therapy
- see Drug regimens for acute gout for drug regimens
starting a discussion about lifelong urate-lowering therapy (see Pharmacological management for chronic gout), with the aim of starting therapy as soon as possible in a patient who presents with acute or chronic gout
- see Information for patients diagnosed with gout for advice on important information for patients to consider when evaluating the benefits of lifelong urate-lowering therapy
addressing modifiable risk factors for gout and optimising the management of associated comorbidities (see Pathogenesis of and risk factors for gout)
considering an alternative drug if a current drug is contributing to gout (eg use of a thiazide or loop diuretic)—if switching to an alternative drug is not possible, reduce the dosage of the contributing drug or manage the excess risk with urate-lowering therapy
starting lifelong urate-lowering therapy, using a treat-to-target approach, to prevent future acute episodes of gout, and to prevent and treat the complications of chronic gout (eg tophi, chronic kidney disease and chronic destructive arthritis)
- see Principles of pharmacological management for chronic gout
- see Drug choice for urate-lowering therapy for advice on an approach to therapy
- see Drug regimens for chronic gout for drug regimens.