Can Gout be cured completely?
Yes, gout is a curable disease. Gout should be cured if treated properly. In fact, it is the only rheumatological disease that can be cured. The key to success is to accept long-term treatment, without becoming discouraged.
This long-term treatment combines a drug treatment that lowers the blood level of uric acid called a hypouricemic drug, and simple measures to reduce risk factors and dietary errors.
It is necessary to reach an adequate level of uric acid in the blood to gradually dissolve the crystals, make the symptoms disappear and prevent irreparable damage to the joints in the long term.
Prevention and treatment of pain is good for patients, but does not address the disorder that causes gout.
To cure gout definitively we will need to dissolve these crystalline accumulations with the appropriate medication, and this is not achieved in days or weeks, but thanks to a treatment well carried out for months and years, depending on each patient. The deposit of uric acid crystals will only be resolved with constant medication, supervised by a physician, and with healthy lifestyle habits.
Hypouricemic treatment is a drug treatment that normalizes uricemia by lowering the amount of uric acid. It favors the dissolution and prevention of the formation of microcrystals in joints or kidneys. This treatment should be continued for as long as possible, and it should be combined with dietary corrections. You should start it when you have gout attacks that recur, if there is gouty arthritis or tophus or if there is renal colic.
To reduce uric acid in the blood, one can either decrease its production or increase its elimination. There are drugs that can block the production of urine acid and drugs that promote elimination of uric acids by the kidneys.
This Hypouricemic therapy aims to lower blood uricemia levels by achieving a level below 60 mg/l (360 Umol/l), and even below 50 mg/l for drops with tophus (300 Umol/l). This number is used as a guideline for increasing daily drug doses. It also represents a target value.
The rapid drop in uric acid can paradoxically cause gout attacks at the beginning of background treatment. This is because it causes the release of microcrystals out of the joint tophus. These attacks are normal and common. These attacks are normal and a sign that the treatment is working. These should not be used to stop the hypouricemic medication, as they could lead to relapse. These temporary inconveniences should be accepted. Treatment to prevent attacks can reduce or eliminate them.
Therefore, it is recommended that you prescribe an anti-crisis treatment, and particularly colchicine, within the first six months of hypouricemic therapy. Sometimes, this may be extended beyond the 6 month period, depending on the advice of your attending physician or rheumatologist.