1 rich Libsyn https://www.libsyn.com 90 600 Interview with Robert H. Shmerling, MD, author of Management of Gout: A 57-Year-Old Man With a History of Podagra, Hyperuricemia, and Mild Renal Insufficiency. Summary Points: Risk factor modification: alcohol intake, excess weight, diet, medications (although overall impact on gout uncertain). Acute gout can be treated with NSAIDs, colchicine, corticosteroids, or a combination of these. Urate-lowering treatment to prevent attacks and tophi is appropriate for certain patients with gout. (In my opinion, allopurinol is the best initial choice to suppress uric acid.) Urate-lowering treatment should suppress uric acid to 6.0 mg/dL or less; allopurinol should start no higher than 100 mg/d but titrate up based on uric acid levels; it is common to require more than 300 mg/d. Concomitant prophylaxis (eg, low-dose colchicine, 0.6 mg/d) is appropriate for 6-9 months or longer. Take home message: We now have new therapies and guidelines for the treatment of gout. Appropriate use of therapeutics for gout&amp;mdash;both new and old&amp;mdash;will provide optimal outcomes for the increasing number of patients with this common disease. Author in the Room™ Interviews http://jamanetwork.com/index.aspx <iframe title="Libsyn Player" style="border: none" src="//html5-player.libsyn.com/embed/episode/id/2187198/height/90/theme/custom/thumbnail/yes/direction/forward/render-playlist/no/custom-color/d71635/" height="90" width="600" scrolling="no" allowfullscreen webkitallowfullscreen mozallowfullscreen oallowfullscreen msallowfullscreen></iframe> https://assets.libsyn.com/secure/content/5320034