What is the treatment of choice for chronic gout?

The treatment of choice for chronic gout is allopurinol, which is a xanthine oxidase inhibitor. It works by reducing the production of uric acid in the body, thereby helping to lower serum uric acid levels. This is particularly important in chronic gout management, as elevated uric acid levels are responsible for the formation of urate crystals in the joints, leading to the painful flare-ups associated with the condition.

Allopurinol is beneficial for patients who experience recurrent gout attacks or have developed complications associated with chronic hyperuricemia, such as tophi or kidney stones. By managing uric acid levels over the long term, allopurinol helps prevent future attacks and can facilitate the resolution of existing tophi.

While colchicine is effective during acute attacks and can be part of a long-term management plan in some cases, it is not considered the primary treatment for chronic gout. Similarly, NSAIDs and intraarticular corticosteroids are usually reserved for controlling acute flares rather than for ongoing management of the underlying hyperuricemia in chronic gout.