Indications for long term drug therapy

Indications for drugs to prevent gout include:

• recurrent attacks (> 1 attack per year)
• chronic arthropathy
• tophi
• urate renal calculi
• renal impairment
• evidence of joint damage such as radiological changes
• who need to continue treatment with diuretics (1)

However, in practice, the decision concerning whether to initiate prophylaxis is often left to patient preference (2).

Reference:

• (1) Jordan KM et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-4
• (2) Drug and Therapeutics Bulletin (2004); 42(5):37-40.