Review Paper:
Modern Perspectives
on Gout: From Pathogenesis to Novel Therapeutic Approaches
Sindhu Phoolsingh and Kavya Manjunath
Res. J. Biotech.; Vol. 21(1); 396-403;
doi: https://doi.org/10.25303/211rjbt3960403; (2026)
Abstract
Gout, a complex form of inflammatory arthritis, has emerged as an increasingly prevalent
condition affecting global populations, with significant impacts on quality of life
and healthcare systems. This comprehensive review examines the intricate pathophysiological
mechanisms, current pharmacological interventions and evolving treatment paradigms
in gout management. The pathophysiology centers on hyperuricemia and the subsequent
deposition of monosodium urate crystals in joints and soft tissues, triggered by
modifiable and non-modifiable risk factors. Recent advances in understanding the
role of the inflammasome (NLRP3) pathway and genetic factors have provided new insights
into disease progression and potential therapeutic targets. The pharmacological
management encompasses three main categories: acute attack medications (including
NSAIDs, colchicine and corticosteroids), urate-lowering therapies (such as xanthine
oxidase inhibitors allopurinol and febuxostat) and prophylactic treatments. Current
treatment guidelines emphasize a 'treat-to-target' approach, aiming for serum urate
levels below 6 mg/dL, while considering individual patient factors and comorbidities.
This review also focuses on new therapies such as Indian, Malaysian and Chinese
herbal medications and innovative treatments including physiotherapy, acupuncture,
joint replacement surgery and laser therapy, showing promise for treatment-resistant
patients. Integrating lifestyle modifications, dietary interventions and patient
education remains crucial for optimal disease management. Understanding these multifaceted
aspects of gout is essential for healthcare providers to implement effective, personalized
treatment strategies and improve patient outcomes.
