Anti-inflammatory prophylaxis—before ULT6
The American College of Rheumatology (ACR) Guidelines for Management of Gout state that patients should begin anti-inflammatory prophylaxis prior to or concurrent with urate-lowering therapy (ULT).6
- The ACR Task Force Panel recommends low-dose colchicine (0.5 mg to 0.6 mg orally once or twice a day) as a first-line option.
- The goal of long-term gout management is to reduce the urate level below the limit of monosodium urate (MSU) solubility, thus dissolving MSU crystals.2
- The dispersion of MSU crystals puts the patient at increased risk of gout flares.7
Flare prophylaxis should continue for at least 3 to 6 months6
Per the ACR Guidelines, anti-inflammatory prophylaxis should continue for the greater of:
- At least 6 months OR
- 3 months after achieving target serum urate appropriate for the patient (no tophi detected on physical exam).
- 6 months after achieving target serum urate appropriate for the patient (one or more tophi detected on physical exam).
Untreated hyperuricemia advances the severity of gout8
Over time, untreated chronic hyperuricemia can increase body urate stores, advancing the severity of the disease.
- In a study of colchicine prophylaxis in 208 patients with acute gouty arthritis, 62% of patients experienced their second acute flare within 1 year of their first gout flare.2
Flare prophylaxis is recommended with urate-lowering therapy (ULT)9-11
The ACR Guidelines for Management of Gout state that patients should begin anti-inflammatory prophylaxis prior to or concurrent with ULT.1 These therapies may not be appropriate for all adult patients; the full Prescribing Information, including contraindications, warnings, precautions, and other dosing considerations should always be consulted.