RISKS AND BENEFITS OF DRUGS USED IN THE MANAGEMENT AND PREVENTION OF GOUT

Nonsteroidal anti-inflammatory drugs (NSAIDs) are now commonly used fo r the treatment of acute gout, but caution is required in view of thei r adverse effects, especially in the elderly. Colchicine is still an e ffective acute agent, but care must be taken to monitor toxicity. Intr a-articular glucocorticosteroid therapy is useful and very safe; oral steroids and corticotrophin (adrenocorticotrophic hormone) may have a small role in acute therapy and seem safe when used over short time sp ans. Low dose colchicine may have a cost and toxicity advantage over N SAIDs in the prophylaxis of gout when commencing therapy aimed at redu cing elevated plasma urate concentrations. Allopurinol is more frequen tly used than uricosuric agents such as probenecid, and toxicity may b e largely avoided by tailoring dosage schedules according to renal fun ction.