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Shekelle PG, FitzGerald J, Newberry SJ, et al. Management of Gout [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Mar. (Comparative Effectiveness Reviews, No. 176.)

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Management of Gout [Internet].

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This figure depicts Key Questions 1, 2, and 5 within the context of the PICOTS described in the previous section to create an analytic framework for the treatment of acute gout. The figure begins with the condition of acute gout. Key question 1 addresses the effects and potential harms (adverse events) associated with pharmacological treatment for an acute gout episode (flare), including the use of NSAIDS, corticosteroids (either oral or infused), and/or colchicine. Key question 2 addresses the role of dietary and/or lifestyle modifications, including a low purine diet, alcohol restriction, improved hydration, use of dietary supplements, increased physical activity, and other changes. In the center of the figure, a box lists possible short-term health outcomes, including pain, joint swelling, and tenderness (short-term being defined as 1-2 days to about a week). An additional potential short term harm is the risk for adverse events. Longer-term outcomes, depicted to the far right, include serum uric acid concentrations, pain, joint swelling and tenderness, ADLs, patient global assessment, and recurrence.

Figure AAnalytic framework for treatment of acute gout

ADLs = activities of daily living; KQ = Key Question; sUA = serum uric acid; ULT = urate lowering therapy

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