Gout and hyperuricemia.

Accurate diagnosis is essential since gout is overdiagnosed by a factor of three. Asymptomatic hyperuricemia is not associated with adverse consequences and should not ordinarily be treated. The acute attack of gout responds to any nonsteroidal anti-inflammatory drug, and antihyperuricemic therapy with allopurinol, probenecid or sulfinpyrazone is effective in lowering uric acid and preventing further attacks. Except for prophylaxis, colchicine is not recommended for the treatment of gout because of unacceptable levels of toxicity. Diet therapy, once a mainstay of treatment, is usually not indicated since drug therapy alone is far more efficacious.