GOUT: THE KING OF DISEASES AND THE DISEASE OF KINGS

Gout is a metabolic disorder caused by hyperuricemia resulting in joints and other tissues deposition of urate crystals. Clinical manifestation includes recurrent attacks of arthritis and accumulation of crystalline deposits called tophi. Gout is considered a progressive disease that, without long-term treatment, can progress to severe tophaceous gout. The disease is increasing in prevalence as a result of changes in diet, lifestyle and environmental factors. Hyperuricemia has a fundamental role as risk factor in the development of gout and seems also to be a risk factor for some comorbidities. The goal of the treatment of gout is to reduce serum uric acid levels sufficiently that crystals can no longer form. A future research agenda should include the identification of genes associated with risk for gout and the development of new urate lowering drugs with a specific target. In the next future, controlled studies are also required to understand the significance and the underlying mechanism of the association between hyperuricemia and some comorbidities.