Gout

In medicine, gout is a "hereditary metabolic disorder characterized by recurrent acute arthritis, hyperuricemia and deposition of sodium urate in and around the joints, sometimes with formation of uric acid calculi."

Treatment
A randomized controlled trial found that patients who used ice packs had better relief of pain with no negative side effects.

Randomized controlled trials find similar benefit from non-steroidal anti-inflammatory agents and oral glucocorticoids. In the first trial, less adverse drug reactions occurred in the glucocorticoids group; however, the NSAID group received a high dose.

In the second randomized controlled trial statistically equal effect resulted from prednisolone 35 mg orally per day or naproxen 500 mg orally per day; however there was an insigificant 8% improvement in the NSAID group.

Colchicine
Colchicine is better than placebo according to a systematic review by the Cochrane Collaboration that found a single randomized controlled trial.

Acute flares
Without treatment, one quarter of flares improve within 2 days.

Diet
Avoiding products with high fructose such as sugary soft drinks (sweetened with high fructose corn syrup), and other high-fructose products, such as fruit juice, apples, and oranges may help.

Xanthine oxidase inhibitors
Allopurinol can reduce frequency of attacks. However, when allopurinol is started, colchicine 0.6 mg twice daily should also be used. In a randomized controlled trial, co-treatment with colchicine 0.6 mg twice daily while allopurinol was tapered up from 100 mg/day until 3 months after the serum urate concentration < 6.5 mg/dl, reduced flares of gout from 77% in the placebo broup to 33% with colchicine prophylaxis. Most of these patients had tophi.

Allopurinol should be increased as possible to achieve a goal serum urate of < 6 mg/dl (360 micromoles/liter).

Febuxostat, a non-purine inhibitor, is equally effective as allopurinol when compared in a randomized controlled trial.

Famous persons with gout
Holy Roman Emperor Charles V had gout and Theodore Roosevelt may have had gout.