New and Pipeline Drugs for Gout
New and Pipeline Drugs for Gout
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DOI：
10.1007/s11926-016-0579-7
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发表时间：
2016-06-01
影响因子：
5
通讯作者：
Schlesinger, Naomi
中科院分区：
文献类型：
--
作者：
Keenan, Robert T.;Schlesinger, Naomi
痛风是西方世界最常见的炎症性关节病。它影响了数百万人，导致工资损失、医疗费用增加和严重残疾，这仍然是受影响者、他们的家庭和医疗保健系统的负担。尽管有许多有效的治疗方法，但痛风往往得不到充分治疗，医生和患者都低估了痛风对患者整体健康和福祉的影响。几十年来，控制急性发作一直是痛风治疗的首要任务。然而，最近，对痛风病理生理学的更深入了解使人们有了新的认识，即痛风对患者的影响远远超出了急性炎症性关节炎的发作范围。反映出该疾病的慢性性质，痛风治疗也需要长期进行，旨在减少痛风的根本原因——高尿酸血症——以及急性发作的症状。因此，治疗需要降低尿酸和抗炎策略。不幸的是，最常用的降尿酸和抗炎治疗对于一些痛风患者来说可能会出现问题，因为他们经常患有多种合并症，从而产生了相对禁忌症。新型降尿酸疗法以及治疗和预防急性痛风发作的新药物不仅可以改善个人护理；它们还可以为那些管理和被管理这种被低估的疾病的人提供更好的教育。在本文中，我们讨论了治疗急性痛风的新药和正在研发的药物、预防性抗炎疗法以及降尿酸疗法。
Gout is the most common inflammatory arthropathy in the western world. Affecting millions and accounting for lost wages, increased health care costs, and significant disability, it remains a burden for those afflicted, their families, and the health care system. Despite the availability of a number of effective therapies, gout is often inadequately treated, and its impact on the patients overall health and well-being is underestimated by physicians and patients alike. For many decades, controlling acute flares was the priority in the management of gout. More recently, however, a deeper understanding of gout pathophysiology has resulted in a new appreciation that gout impacts the patient with consequences well beyond the episodes of acute inflammatory arthritis. Reflecting the chronic nature of the disease, gout treatment needs to be chronic as well, and aimed at reducing the underlying cause of gout-hyperuricemia-as well as the symptom of acute attacks. Therapy therefore requires both urate lowering and anti-inflammatory strategies. Unfortunately, the most commonly used urate lowering and anti-inflammatory treatments may be problematic in some gout patients, who often have multiple comorbidities that establish relative contraindications. Novel urate lowering therapies, and new medications to treat and prevent acute gouty flares, can not only improve care of the individual; they can also lead to a better discourse for the edification of those who manage and are managed for this underestimated disease. In this paper, we discuss new and pipeline drugs for acute gout, prophylactic anti-inflammatory therapies as well as urate lowering therapies.