Emerging therapies in the long-term management of hyperuricaemia and XXXX .

@entity1 @entity8 @entity697 @entity625 @entity3624 @entity5 @entity20082 @entity13579 @entity210 @entity208 @entity11368 @entity414
Gout is a common chronic @entity625 that can lead to significant disability. Gout is one of the few rheumatological conditions that can be diagnosed with certainty, has a known cause and can be cured with appropriate therapy. Hypouricaemic agents reduce @entity414 concentrations through inhibiting @entity414 production ( @entity208 ) or enhancing @entity414 excretion (probenecid, @entity11368 ). @entity208 is the most commonly used hypouricaemic agent but at recommended doses often fails to reduce adequately @entity414 concentrations and prevent @entity697 . The use of probenecid is limited by lack of efficacy in @entity8 . In the last few years, new agents in the management of hyperuricaemia and @entity210 have become available. @entity20082 , a new @entity3624 oxidase inhibitor, is an effective hypouricaemic agent although further data are required for @entity1 with @entity8 and other significant medical conditions. Rasburicase, a recombinant uricase (which catalyses the conversion of @entity414 to the more readily excreted @entity13579 ) is available for prevention of @entity5 . However, its repeated use, as would be required in chronic @entity210 , is limited by antigenicity. A less antigenic PEGylated uricase can rapidly reduce serum @entity414 concentrations and promote resorption of tophi. However, further information with regard to the long-term risks and benefits of these agents is required. These agents may ultimately be used in the short term to rapidly deplete urate stores (induction therapy) followed by long-term therapy with an alternative hypouricaemic agent to prevent subsequent accumulation of @entity414 (maintenance therapy).
