When should drug therapy be used for hyperuricemia and gout?

Gout caused by hyperuricemia is usually an indication for initiating pharmacological treatment under the following circumstances: 1. **Acute gout attack**: During an acute gout attack, if the pain is severe, symptomatic relief can be achieved with the help of nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. Once symptoms have subsided, physicians may consider long-term medication to prevent future attacks. 2. **Recurrent attacks**: If gout attacks occur more than twice a year, or if joint function is impaired, drug therapy is necessary to prevent joint damage and tophi formation. 3. **Asymptomatic hyperuricemia**: Patients with risk factors for cardiovascular disease or those who already have cardiovascular conditions may require pharmacological intervention to control uric acid levels, even in the absence of gout attacks. 4. **Uric acid stones or renal impairment**: Hyperuricemia can lead to uric acid stone formation or kidney problems; in such cases, pharmacological intervention aims to prevent further renal damage. Medical treatment includes medications that inhibit uric acid production and those that promote uric acid excretion. Consultation with a physician is recommended before initiating drug therapy.