NSAID: nonsteroidal antiinflammatory drug; GI: gastrointestinal; PPI: proton pump inhibitor; eGFR: estimated glomerular filtration rate.
* This algorithm is applicable to nonpregnant adult gout patients who do not have an organ transplant.
¶ For additional information, refer to the UpToDate topic on the clinical manifestations and diagnosis of gout.
Δ For additional information, including specific dosing and treatment regimens, as well as other details, refer to the UpToDate topic on treatment of gout flares. In patients not already receiving long-term urate-lowering therapy who present with a flare, clinicians should discuss plans for such therapy. Ongoing urate-lowering therapy should be continued during treatment of the gout flare. For additional information, refer to the UpToDate topics on lifestyle modification and other strategies to reduce the risk of gout flares and progression of gout and on pharmacologic urate-lowering therapy and treatment of tophi in patients with gout.
◊ Anakinra is reserved for use in patients who have frequent flares and in whom first-line therapies are ineffective, contraindicated, or not tolerated.