Optimal Management of Gout in Older Patients

Emilio B. Gonzalez, Stephen B. Miller, Carlos A. Agudelo

Research output: Contribution to journalReview article

21 Scopus citations

Abstract

Gout in older patients tends to be sub-acute to chronic, often tophaceous, polyarticular, erosive, symmetrical, and causes persistent, recurrent and chronic arthritis. Clinically, it may closely mimic rheumatoid arthritis; thus, a correct diagnosis requires a high index of clinical suspicion and the identification of uric acid crystals. An optimal therapeutic strategy for most older patients with chronic tophaceous gout could involve the following: avoidance of alcohol and diuretic use if possible; avoidance of long term nonsteroidal anti-inflammatory drug (NSAID) therapy; use of short term corticosteroids (systemic or intra-articular) for acute exacerbations; prophylactic colchicine daily or every other day according to the degree of renal dysfunction present; and long term allopurinol therapy in dosages adjusted to the degree of hyperuricaemia and renal dysfunction.

Original languageEnglish (US)
Pages (from-to)128-134
Number of pages7
JournalDrugs & Aging
Volume4
Issue number2
DOIs
StatePublished - Feb 1994
Externally publishedYes

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Pharmacology (medical)

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