Therapeutic challenges in the management of gout in the elderly.

Gout is the most common inflammatory arthritis in the elderly population. Management in the elderly requires special consideration. Physiologic changes associated with aging and co-morbidities make the elderly prone to adverse effects of drugs otherwise successfully used in younger counterparts. Use of colchicine, non-steroidal anti-inflammatory drugs, and urate-lowering therapies may be restricted in those with limited renal reserve. Corticosteroids are safe alternatives for short-term use in acute gout. Elderly patients need laboratory monitoring for side effects more frequently than usual. Non-pharmacologic measures such as dietary modifications, regular exercise, and ice therapy should be considered vital adjunctive treatments. A brief review of future therapies is also discussed.