June 30, 2022

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How should gout be treated?

How should gout be treated?

 

How should gout be treated? Should I always take uric acid lowering drugs? Know these three points and reduce the dose of medication.

Many gout patients who have taken uric acid-lowering drugs have this phenomenon: once the drug is stopped, uric acid will rebound immediately.

How should gout be treated?

Many gout patients who have taken uric acid-lowering drugs have this phenomenon: once the drug is stopped, uric acid will rebound immediately. In desperation, I can only take the medication again, and then once the medication is stopped again, the same phenomenon will occur, making many gout patients believe that gout cannot be stopped. So why does this phenomenon occur, is it really impossible to stop gout?


How should gout be treated?

Many gout patients hope that after taking a medicine, uric acid can return to normal, and gout will not occur, and they will be completely free from the troubles of gout. Although our doctors have the same desires as patients, the ideal is still beautiful after all, but the reality is difficult to accept.

Although the long-term level of blood uric acid can make gout attacks less or even no attacks, it is like a marathon, patients need to persist for a long time, and must not think of being able to reach the sky in one step. In addition, the current uric acid-lowering drugs are generally symptomatic treatments, often focusing on the mechanism of uric acid elevation, but they have not fundamentally solved the problem of uric acid elevation.

Therefore, the uric acid-lowering drugs taken by the patient did not actually solve the cause of hyperuricemia. Once the patient stops using the uric acid-lowering drugs, blood uric acid will rise again. In this respect, as far as the current medical level is concerned, hyperuricemia can only be effectively controlled but cannot be eradicated.


Causes of blood uric acid rebound

The main reason for the increase in blood uric acid rebound after treatment in most gout patients is improper drug discontinuation. In fact, the reasons for the increase in uric acid in hyperuricemia patients are different, and the mechanisms leading to uric acid rebound are also different.


1. Poor uric acid excretion type

For such patients, after taking uric acid-lowering drugs, the serum uric acid concentration can be reduced, but it will cause the urate deposited in the tissue to dissolve. If the drug is stopped at this time, the urate crystals that have been dissolved will stay in the body, causing a “rebound phenomenon”, which is what we often call the “crystal dissolution reaction”.

2. Excessive uric acid production

Because patients lack an enzyme called purine metabolizing enzyme, this type of patients usually suffer from uric acid metabolism disorders. This disorder can lead to increased uric acid production in the body. If you do not continue to take drugs that lower uric acid, the uric acid in the body will rise again.

3. Hybrid

Uric acid excretion is not a problem in this type of patients, but the clearance rate is generally low. If the patient does not continue to take uric acid lowering drugs, uric acid will exceed the standard and the uric acid level will rise again.


How much uric acid should be reduced?

  • 1. Tophi should be less than 300μmol/L.
  • 2. Those without tophi should be less than 360μmol/L…
  • 3. The serum uric acid of patients with hyperuricemia is still greater than 420μmol/L without drug treatment.
  • 4. Hyperuricemia patients with cardiovascular and cerebrovascular diseases should be reduced to about 360 μmol/L.

In fact, the dosage and time of uric acid lowering drugs should be adjusted according to the blood uric acid level. As for whether to stop the drug, it depends on each person. It is recommended not to reduce the drug by yourself, but the patient can reduce the drug as appropriate under the guidance of the doctor. Patients should also pay attention to their daily care in life, monitor the blood uric acid index at any time, and contact the doctor immediately if the blood uric acid index fluctuates.

 

(sourceinternet, reference only)


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