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TREATMENT OF GOUT

TREATMENT OF GOUT Abstract RAPID progress has been made in recent years in the management of gout, one of man's oldest diseases. Today the patient with gouty arthritis can be effectively relieved during acute attacks and protected from recurrent bouts, and if tophi exist they can be reduced in size. This optimistic outlook depends, first, upon the physician's knowledge of the therapeutic measures available and, second, upon the patient's willingness to submit to uninterrupted life-time therapy. Few illnesses follow such a set clinical pattern as does classical gout. Hench has described two stages—that characterized by recurrent episodes of acute joint inflammation followed by complete, but temporary, remissions (intercritical periods) and that of chronic gouty arthritis, or tophaceous gout.1 Because asymptomatic hyperuricemia (larval gout) precedes for some time attacks of acute joint symptoms, it is proposed that this part of the total disease be designated as the first stage of gout. For the purpose References 1. References 2 and 3. 2. References 4 and 6 3. Graham and Roberts.5 4. A natural alkaloid isolated from the meadow saffron (Colchicum autumnale) and differing chemically from colchicine in that a methyl group replaces an acetyl group at the N-position; supplied as Colcemid by Dr. John Saunders, of Ciba Pharmaceutical Products, Inc., Summit, N. J. 5. References 8 and 9. 6. References 12-16. 7. References 12-14. 8. References 20 and 21. 9. References 22 and 23. 10. Hollander, J. L.: Personal communication to the authors. 11. References 22 and 25-27. 12. References 15, 22, 25, and 29. 13. All clearance ratios in this paper have been multiplied by 100. 14. Hench, P. S.: The Diagnosis of Gout and Gouty Arthritis , J. Lab. & Clin. Med. 22:48-53 ( (Oct.) ) 1936. 15. Smyth, C. J.; Cotterman, C. W., and Freyberg, R. H.: The Genetics of Gout and Hyperuricemia: An Analysis of 19 Families , J. Clin. Invest. 27:749-759 ( (Nov.) ) 1948. 16. Stecher, R. M.; Hersh, A. H., and Solomon, W. M.: The Heredity of Gout and Its Relationship to Familial Hyperuricemia , Ann. Int. Med. 31:595-614 ( (Oct.) ) 1949. 17. Graham, W., and Roberts, J. B.: Intravenous Colchicine in the Management of Gouty Arthritis , Ann. Rheumat. Dis. 12:16-19 ( (March) ) 1953. 18. Graham, W., and Roberts, J. B.: Intravenous Colchicine in the Management of Gouty Arthritis , Ann. Rheum. Dis. 13:367-368 ( (Dec.) ) 1954. 19. Finn, N.: The Gouty Diathesis with Special Reference to Indians in South Africa , South African M. J. 23:276-280 ( (April) ) 1949. 20. Finn, N.: The Use of Colchicine in Gout, Correspondence , Ann. Rheumat. Dis. 13:163 ( (June) ) 1954. 21. Moeschlin, S.; Meyer, H., and Lichtman, A.: Ein neues Colchicum-Nebenalkaloid (Demecolcin Ciba) als Cytostaticum myeloischer Leukämien , Schweiz. med. Wchnschr. 83:990-994 ( (Oct. 10) ) 1953. 22. Leonard, B. J., and Wilkinson, J. F.: Desacetylmethylcolchicine in Treatment of Myeloid Leukaemia , Brit. M. J. 1:874-877 ( (April 9) ) 1955. 23. Kuzell, W. C.; Schaffarzick, R. W., and Naugler, W. E.: The Effect of Intravenous Demecolcine (Colcemide) on Acute Gout , A. M. A. Arch. Int. Med. 96:153-165 ( (Aug.) ) 1955. 24. Closky, J.; Wallace, S., and Banowitch, M. M.: Desacetylmethylcolchicine in Acute Gouty Arthritis , New England J. Med. 253:730-732 ( (Oct. 27) ) 1955. 25. Steinbrocker, O.; Neustadt, D. H., and Ehrlick, M.: Butazolidin in the Treatment of Gout with a Comparison with Other Agents , M. Clin. North America 38:611-624 ( (March) ) 1954. 26. MacKnight, J. C.; Irby, R., and Toone, E. C., Jr.: Phenylbutazone in Management of Rheumatoid Arthritis, Reumatoid Spondylitis and Gouty Arthritis , Geriatrics 9:111-115 ( (March) ) 1954. 27. Kuzell, W. C.; Schaffarzick, R. W.; Naugler, W. E.; Gaudin, G.; Mankle, E. A., and Brown, B.: Phenylbutazone (Butazolidin) in Gout , Am. J. Med. 16:212-217 ( (Feb.) ) 1954. 28. Lockie, L. M.: Present-Day Treatment of Gout , Bull. Rheumat. Dis. 6:97-98 ( (Nov.) ) 1955. 29. Wilson, G. M., Jr.; Huffman, E. R., and Smyth, C. J.: Oral Phenylbutazone in the Treatment of Acute Gouty Arthritis , Am. J. Med. , to be published. 30. Kuzell, W. C.; Schaffarzick, R. W.; Naugler, W. E.; Gaudin, G., and Mankle, E. A.: Phenylbutazone: Further Clinical Evaluation , A. M. A. Arch. Int. Med. 92:646-661 ( (Nov.) ) 1953. 31. Johnson, H. P., Jr.; Engleman, E. P.; Forsham, P. H.; Krupp, M. A.; Green, T. W., and Goldfien, A.: Effects of Phenylbutazone in Gout , New England J. Med. 250:665-670 ( (April 22) ) 1954. 32. Huffman, E. R.; Wilson, G. M.; Smyth, C. J., and Hill, R.: Metabolic Effect of Phenylbutazone in Gouty and Non-Gouty Arthritis , Ann. Rheumat. Dis. 13:317-323 ( (Dec.) ) 1954. 33. Brodie, B. B.; Yu, T. F.; Burns, J. J.; Chenkin, T.; Paton, B. C.; Steele, J. M., and Gutman, A. B.: Observations on G-25671, a Phenylbutazone Analogue (4-(Phenylthioethyl)-1,2-Diphenyl 3,5 Pyrazolidinedione) , Proc. Exper. Biol. & Med. 86:884-887 ( (Aug.-Sept.) ) 1954. 34. Von Wilhelmi, G., and Currie, J. P.: Über die pharmakologischen und klinischen Eigenschaften von G-25671 (Geigy Basel), einem neuen Prepärataus der Pyrazolidinreihe , Schweiz. med. Wchnschr. 84:1315-1318 ( (Nov. 20) ) 1954. 35. Gutman, A. B., and Yu, T. F.: Current Principles of Management in Gout , Am. J. Med. 13:744-759 ( (Dec.) ) 1952.Crossref 36. Wolfson, W. G.; Thompson, R. E.; Robinson, W. D.; Duff, I. F.; Cohn, C.; Lewis, L., and Hunt, H. D.: The Development, Evaluation and Clinical Use of Long-Acting ACTH Preparations, in Proceedings of the Second Clinical ACTH Conference, edited by J. R. Mote, Philadelphia, The Blakiston Company, 1951, Vol. 2, p. 1. 37. Hollander, J. L.: Intra-Articular Hydrocortisone in the Treatment of Arthritis , Ann. Int. Med. 39:735-746 ( (Oct.) ) 1953.Crossref 38. Gutman, A. B., and Yu, T. F.: Prevention and Treatment of Chronic Gouty Arthritis , J. A. M. A. 157:1096-1102 ( (March 26) ) 1955.Crossref 39. Bartels, E. C.: Gout—Now Amenable to Control , Ann. Int. Med. 42:1-10 ( (Jan.) ) 1955.Crossref 40. Marson, F. G. W.: Studies in Gout, with Particular Reference to the Value of Sodium Salicylate in Treatment , Quart. J. Med. 22:331-346 ( (July) ) 1953. 41. Yu, T. F., and Gutman, A.: Paradoxial Retention of Uric Acid by Uricosuric Drugs in Low Dosage , Proc. Soc. Exper. Biol. & Med. 90:542-547 ( (Nov.) ) 1955. 42. Talbott, J. H.: The Treatment of Gout and Gouty Arthritis , Cincinnati J. Med. 33:291-298 ( (Aug.) ) 1952. 43. Kuzell, W. C., and Schaffarzick, R. W.: Phenylbutazone (Butazolidin) and Butapyrin: Study of Clinical Effects in Arthritis and Gout , California Med. 77:319-325 ( (Nov.) ) 1952. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

TREATMENT OF GOUT

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References (30)

Publisher
American Medical Association
Copyright
Copyright © 1956 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1956.00250240135014
Publisher site
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Abstract

Abstract RAPID progress has been made in recent years in the management of gout, one of man's oldest diseases. Today the patient with gouty arthritis can be effectively relieved during acute attacks and protected from recurrent bouts, and if tophi exist they can be reduced in size. This optimistic outlook depends, first, upon the physician's knowledge of the therapeutic measures available and, second, upon the patient's willingness to submit to uninterrupted life-time therapy. Few illnesses follow such a set clinical pattern as does classical gout. Hench has described two stages—that characterized by recurrent episodes of acute joint inflammation followed by complete, but temporary, remissions (intercritical periods) and that of chronic gouty arthritis, or tophaceous gout.1 Because asymptomatic hyperuricemia (larval gout) precedes for some time attacks of acute joint symptoms, it is proposed that this part of the total disease be designated as the first stage of gout. For the purpose References 1. References 2 and 3. 2. References 4 and 6 3. Graham and Roberts.5 4. A natural alkaloid isolated from the meadow saffron (Colchicum autumnale) and differing chemically from colchicine in that a methyl group replaces an acetyl group at the N-position; supplied as Colcemid by Dr. John Saunders, of Ciba Pharmaceutical Products, Inc., Summit, N. J. 5. References 8 and 9. 6. References 12-16. 7. References 12-14. 8. References 20 and 21. 9. References 22 and 23. 10. Hollander, J. L.: Personal communication to the authors. 11. References 22 and 25-27. 12. References 15, 22, 25, and 29. 13. All clearance ratios in this paper have been multiplied by 100. 14. Hench, P. S.: The Diagnosis of Gout and Gouty Arthritis , J. Lab. & Clin. Med. 22:48-53 ( (Oct.) ) 1936. 15. Smyth, C. J.; Cotterman, C. W., and Freyberg, R. H.: The Genetics of Gout and Hyperuricemia: An Analysis of 19 Families , J. Clin. Invest. 27:749-759 ( (Nov.) ) 1948. 16. Stecher, R. M.; Hersh, A. H., and Solomon, W. M.: The Heredity of Gout and Its Relationship to Familial Hyperuricemia , Ann. Int. Med. 31:595-614 ( (Oct.) ) 1949. 17. Graham, W., and Roberts, J. B.: Intravenous Colchicine in the Management of Gouty Arthritis , Ann. Rheumat. Dis. 12:16-19 ( (March) ) 1953. 18. Graham, W., and Roberts, J. B.: Intravenous Colchicine in the Management of Gouty Arthritis , Ann. Rheum. Dis. 13:367-368 ( (Dec.) ) 1954. 19. Finn, N.: The Gouty Diathesis with Special Reference to Indians in South Africa , South African M. J. 23:276-280 ( (April) ) 1949. 20. Finn, N.: The Use of Colchicine in Gout, Correspondence , Ann. Rheumat. Dis. 13:163 ( (June) ) 1954. 21. Moeschlin, S.; Meyer, H., and Lichtman, A.: Ein neues Colchicum-Nebenalkaloid (Demecolcin Ciba) als Cytostaticum myeloischer Leukämien , Schweiz. med. Wchnschr. 83:990-994 ( (Oct. 10) ) 1953. 22. Leonard, B. J., and Wilkinson, J. F.: Desacetylmethylcolchicine in Treatment of Myeloid Leukaemia , Brit. M. J. 1:874-877 ( (April 9) ) 1955. 23. Kuzell, W. C.; Schaffarzick, R. W., and Naugler, W. E.: The Effect of Intravenous Demecolcine (Colcemide) on Acute Gout , A. M. A. Arch. Int. Med. 96:153-165 ( (Aug.) ) 1955. 24. Closky, J.; Wallace, S., and Banowitch, M. M.: Desacetylmethylcolchicine in Acute Gouty Arthritis , New England J. Med. 253:730-732 ( (Oct. 27) ) 1955. 25. Steinbrocker, O.; Neustadt, D. H., and Ehrlick, M.: Butazolidin in the Treatment of Gout with a Comparison with Other Agents , M. Clin. North America 38:611-624 ( (March) ) 1954. 26. MacKnight, J. C.; Irby, R., and Toone, E. C., Jr.: Phenylbutazone in Management of Rheumatoid Arthritis, Reumatoid Spondylitis and Gouty Arthritis , Geriatrics 9:111-115 ( (March) ) 1954. 27. Kuzell, W. C.; Schaffarzick, R. W.; Naugler, W. E.; Gaudin, G.; Mankle, E. A., and Brown, B.: Phenylbutazone (Butazolidin) in Gout , Am. J. Med. 16:212-217 ( (Feb.) ) 1954. 28. Lockie, L. M.: Present-Day Treatment of Gout , Bull. Rheumat. Dis. 6:97-98 ( (Nov.) ) 1955. 29. Wilson, G. M., Jr.; Huffman, E. R., and Smyth, C. J.: Oral Phenylbutazone in the Treatment of Acute Gouty Arthritis , Am. J. Med. , to be published. 30. Kuzell, W. C.; Schaffarzick, R. W.; Naugler, W. E.; Gaudin, G., and Mankle, E. A.: Phenylbutazone: Further Clinical Evaluation , A. M. A. Arch. Int. Med. 92:646-661 ( (Nov.) ) 1953. 31. Johnson, H. P., Jr.; Engleman, E. P.; Forsham, P. H.; Krupp, M. A.; Green, T. W., and Goldfien, A.: Effects of Phenylbutazone in Gout , New England J. Med. 250:665-670 ( (April 22) ) 1954. 32. Huffman, E. R.; Wilson, G. M.; Smyth, C. J., and Hill, R.: Metabolic Effect of Phenylbutazone in Gouty and Non-Gouty Arthritis , Ann. Rheumat. Dis. 13:317-323 ( (Dec.) ) 1954. 33. Brodie, B. B.; Yu, T. F.; Burns, J. J.; Chenkin, T.; Paton, B. C.; Steele, J. M., and Gutman, A. B.: Observations on G-25671, a Phenylbutazone Analogue (4-(Phenylthioethyl)-1,2-Diphenyl 3,5 Pyrazolidinedione) , Proc. Exper. Biol. & Med. 86:884-887 ( (Aug.-Sept.) ) 1954. 34. Von Wilhelmi, G., and Currie, J. P.: Über die pharmakologischen und klinischen Eigenschaften von G-25671 (Geigy Basel), einem neuen Prepärataus der Pyrazolidinreihe , Schweiz. med. Wchnschr. 84:1315-1318 ( (Nov. 20) ) 1954. 35. Gutman, A. B., and Yu, T. F.: Current Principles of Management in Gout , Am. J. Med. 13:744-759 ( (Dec.) ) 1952.Crossref 36. Wolfson, W. G.; Thompson, R. E.; Robinson, W. D.; Duff, I. F.; Cohn, C.; Lewis, L., and Hunt, H. D.: The Development, Evaluation and Clinical Use of Long-Acting ACTH Preparations, in Proceedings of the Second Clinical ACTH Conference, edited by J. R. Mote, Philadelphia, The Blakiston Company, 1951, Vol. 2, p. 1. 37. Hollander, J. L.: Intra-Articular Hydrocortisone in the Treatment of Arthritis , Ann. Int. Med. 39:735-746 ( (Oct.) ) 1953.Crossref 38. Gutman, A. B., and Yu, T. F.: Prevention and Treatment of Chronic Gouty Arthritis , J. A. M. A. 157:1096-1102 ( (March 26) ) 1955.Crossref 39. Bartels, E. C.: Gout—Now Amenable to Control , Ann. Int. Med. 42:1-10 ( (Jan.) ) 1955.Crossref 40. Marson, F. G. W.: Studies in Gout, with Particular Reference to the Value of Sodium Salicylate in Treatment , Quart. J. Med. 22:331-346 ( (July) ) 1953. 41. Yu, T. F., and Gutman, A.: Paradoxial Retention of Uric Acid by Uricosuric Drugs in Low Dosage , Proc. Soc. Exper. Biol. & Med. 90:542-547 ( (Nov.) ) 1955. 42. Talbott, J. H.: The Treatment of Gout and Gouty Arthritis , Cincinnati J. Med. 33:291-298 ( (Aug.) ) 1952. 43. Kuzell, W. C., and Schaffarzick, R. W.: Phenylbutazone (Butazolidin) and Butapyrin: Study of Clinical Effects in Arthritis and Gout , California Med. 77:319-325 ( (Nov.) ) 1952.

Journal

A.M.A. Archives of Internal Medicine – American Medical Association

Published: Jun 1, 1956

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