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GPs lack evidence on treatments for gout

Patients with gout should have greater say over how they are treated in the absence of hard evidence to back up GPs' decisions, according to a report.

The report, published in Drugs and Therapeutics Bulletin earlier this month, claimed there is no definitive evidence on the best treatment for gout or any studies establishing indometacin as the most effective drug.

It also said the evidence for alternatives to NSAIDs, such as colchicine and steroids, was most often anecdotal, while there were no published controlled trials for the effect of lifestyle changes on the frequency of attacks.

Drugs and Therapeutics Bulletin editor Joe Collier said: 'It is astonishing that we know so little about how best to treat gout. The drugs used are old, so there is no drive to do the necessary research.'

Dr Steve Longworth, a GP in Leicester and past-president of the Primary Care Rheumatology Society, conceded there was a lack of data but said:

'On purely empirical evidence, anti-inflammatories work well.'

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