diclofenac, indometacin or naproxen at maximum dose is the drug … Objective: To provide guidance for the management of gout, including indications for and optimal use of urate-lowering therapy (ULT), treatment of gout flares, and lifestyle and other medication recommendations. 1 agents used in the management of gout. Guideline for the management of polymyalgia rheumatica. NHS Fife Gout Management Guidelines Figure 1. ULT is required but allopurinol and febuxostat are not tolerated, contraindicated or inadequate in lowering serum uric acid levels to target. Gout is a disabling and common disease in Europe; its prevalence ranges from 0.9% to 2.5% depending on the country.1–3 The prevalence and incidence of the disease have increased steadily in recent years, particularly in the UK.4, 5 However, despite effective treatments, gout is still often misdiagnosed and its management remains suboptimal.3, 6, 7 This situation prompted the elaboration … 0000003171 00000 n 0000014048 00000 n 0000003790 00000 n Review new diagnostic technologies for adoption in the NHS. [Guideline] Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al. Swelling, effusion, warmth, erythema, and/or tenderness of the involved joint(s). Prescribing and Technical Information (24), British and Irish Hypertension Society - BIHS (1), British Association for Sexual Health and HIV - BASHH (1), electronic Medicines Compendium - eMC (12), European League Against Rheumatism - EULAR (2), National Institute for Health and Care Excellence - NICE (17), National Rheumatoid Arthritis Society - NRAS (1), NIHR Journals Library - Health Services and Delivery Research (1), Royal College of Psychiatrists - RCPsych (1), Scottish Intercollegiate Guidelines Network - SIGN (1), WHO Regional Office for Europe - WHO Europe (1), View options for downloading these results. [National Clinical Guideline Centre, 2011; NICE, 2019] Contraindications and cautions. Start anti-inflammatory/analgesic therapy straight away and continue for 1 – 2 weeks 0000025344 00000 n However, these documents contain inconsistent recommendations with unclear quality profiles. Oldest - newest. Thiazide-type diuretics should be avoided in: People with: Refractory hypokalaemia. Review the evidence across broad health and social care topics. It is also common in the midfoot, ankle, knee, fingers, wrist and elbow joints although can effect any joint. By mouth. Electronic Medicines Compendium. Published by National Institute for Health and Care Excellence (NICE), 10 March 2015. startxref Published by National Institute for Health and Care Excellence (NICE), 10 March 2015 A Cochrane review found limited evidence from randomised controlled trials to support the efficacy and safety of allopurinol over placebo and other urate-lowering medicines in chronic gout. 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