As a general rule, asymptomatic hyperuricemia should not be treated. Patients with levels higher than 11 mg/dL who overexcrete uric acid are at risk for renal stones and renal impairment; therefore, renal function should be monitored in these individuals. Tophi should not be surgically removed unless they are in a critical location or drain chronically.
Although colchicine was once the treatment of choice for acute gout, it is now less commonly used than nonsteroidal anti-inflammatory drugs because of its narrow therapeutic window and risk for toxicity. To be effective, colchicine therapy is ideally initiated within 36 hours of onset of the acute attack.
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Cite this: Herbert S. Diamond. Fast Five Quiz: Are You Prepared to Confront Gout? - Medscape - Dec 10, 2015.