Gout is the articular manifestation of a systemic metabolic disorder – hyperuricemia. The causes of hyperuricemia and its epidemiology have been intensely investigated these last 10 years, and there is an increasing awareness that apart from gout, hyperuricemia is associated with cardiovascular disease and the metabolic syndrome. Recent research has tried to untangle these links and to determine their etiological relationship in man, based on cohort studies and GWAS approaches. A number of novel genes/molecules have been identified and their contribution to the development of gout is being investigated.
Persistent hyperuricemia is a major risk factor for the development of gout, an acute inflammatory reaction to MSU crystals deposited in and around the joint. Recent advances in articular imaging by ultrasound and dual energy CT have shown that deposits of MSU are found in the absence of overt inflammation, and suggest that there is a pre-clinical phase of gout. Finally, the therapy of hyperuricemia and of gouty inflammation has seen major drug developments in the last five years. These new drugs should provide the clinician with a larger range of options in the management of gout and hyperuricemia.
Disclosure of Interest A. So Consultant for: Novartis, Ardea Biosciences, Menarini, Speakers Bureau: Menarini
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