{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T07:40:22Z","timestamp":1677483622208},"reference-count":32,"publisher":"Hogrefe Publishing Group","issue":"6","license":[{"start":{"date-parts":[[2020,4,1]],"date-time":"2020-04-01T00:00:00Z","timestamp":1585699200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Praxis"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:p> Zusammenfassung. Bei Gicht steht im klinischen Alltag meist die akute Attacke im Vordergrund. Als diagnostischer Goldstandard gilt dabei der Kristallnachweis in der Gelenksfl\u00fcssigkeit mittels Polarisationsmikroskopie. Auch bildgebende Verfahren wie der hochaufl\u00f6sende Ultraschall sind von Nutzen. Zur Behandlung der akuten Gichtattacke dienen nicht-steroidale Antirheumatika, Steroide und Colchizin (in der Schweiz nicht zugelassen, \u00fcber Apotheken erh\u00e4ltlich). Ebenso wichtig wie Diagnose und Therapie der akuten Attacke ist aber die langfristige Behandlung der Hyperurik\u00e4mie, um so weitere Gichtsch\u00fcbe sowie m\u00f6gliche renale, kardiale oder metabolische Komplikationen zu verhindern. Daher sollte bei best\u00e4tigter Gichtdiagnose neben nicht-medikament\u00f6sen Massnahmen auch eine harns\u00e4uresenkende Therapie, mit dem Zielwert von &lt;360 \u00b5mol\/l (&lt;6 mg\/dl), erfolgen. Mittel der ersten Wahl stellen dabei Xanthinoxidasehemmer dar. Das Erreichen des Therapieziels ist regelm\u00e4ssig zu \u00fcberpr\u00fcfen und die Therapie allenfalls anzupassen. Resolution of an acute attack is usually the prime objective in routine clinical management of gout. Crystal identification in synovial fluid by polarised light microscopy is considered the diagnostic gold standard. Imaging procedures such as high-resolution ultrasonography are also useful. Non-steroidal anti-inflammatory drugs, steroids and colchicine (not approved in Switzerland, available from pharmacies) are used to treat an acute gout attack. Just as important as the diagnosis and treatment of an acute attack is the long-term management of hyperuricaemia in order to prevent further gout attacks as well as possible renal, cardiac or metabolic complications. Therefore, patients with a confirmed diagnosis of gout should, apart from non-pharmacologic interventions, receive hypouricaemic therapy with a target uric acid level of &lt;360 \u00b5mol\/l (&lt;6 mg\/dl). Drugs of first choice are xanthine oxidase inhibitors. Achievement of the therapeutic objective should be periodically reviewed, adjusting therapy as necessary. Dans la pratique clinique, la crise aigu\u00eb figure le plus souvent au premier plan des cas de goutte. Le crit\u00e8re diagnostique de r\u00e9f\u00e9rence reste cependant la d\u00e9tection des cristaux dans le liquide synovial par microscopie \u00e0 polarisation. Les techniques d\u2019imagerie telles que l\u2019\u00e9chographie \u00e0 haute r\u00e9solution sont \u00e9galement utiles. Les anti-inflammatoires non st\u00e9ro\u00efdiens, les st\u00e9ro\u00efdes et la colchicine (non agr\u00e9\u00e9 en Suisse, mais disponible dans les pharmacies) sont utilis\u00e9s pour traiter les crises de goutte aigu\u00eb. Le traitement au long cours de l\u2019hyperuric\u00e9mie est n\u00e9anmoins tout aussi important que le diagnostic et le traitement des crises aigu\u00ebs, ceci afin de pr\u00e9venir d\u2019autres crises de goutte et d\u2019\u00e9ventuelles complications r\u00e9nales, cardiaques ou m\u00e9taboliques. Par cons\u00e9quent, si le diagnostic de goutte est confirm\u00e9, il convient d\u2019instaurer, en plus des mesures non m\u00e9dicamenteuses, un traitement hypo-uric\u00e9miant avec la valeur cible de &lt;360 \u00b5mol\/l (&lt;6 mg\/dl), les m\u00e9dicaments de premier choix \u00e9tant ici les inhibiteurs de la xanthine-oxydase. L\u2019atteinte de l\u2019objectif th\u00e9rapeutique doit \u00eatre r\u00e9guli\u00e8rement v\u00e9rifi\u00e9e et le traitement adapt\u00e9 si n\u00e9cessaire. <\/jats:p>","DOI":"10.1024\/1661-8157\/a003461","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T04:00:28Z","timestamp":1588132828000},"page":"439-445","source":"Crossref","is-referenced-by-count":0,"title":["Die Gicht und ihr Management in der Praxis"],"prefix":"10.1024","volume":"109","author":[{"given":"Thomas","family":"Langenegger","sequence":"first","affiliation":[{"name":"Medizinische Klinik, Zuger Kantonsspital AG, Baar"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Krebs","sequence":"additional","affiliation":[{"name":"Rheumatologische Praxis, Kloten und Klinik f\u00fcr Rheumatologie,                     Universit\u00e4tsspital Z\u00fcrich"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Rosemann","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Hausarztmedizin, Universit\u00e4t                     Z\u00fcrich"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"H\u00fcgle","sequence":"additional","affiliation":[{"name":"Service de rhumatologie, Centre hospitalier universitaire vaudois                     (CHUV), Lausanne"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes von","family":"Kempis","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Rheumatologie, Kantonsspital St. Gallen"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"101","reference":[{"key":"c1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22660"},{"key":"c2","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-201254"},{"key":"c3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204463"},{"key":"c4","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2014.124"},{"key":"c5","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hct083"},{"key":"c6","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2011.09.033"},{"key":"c7","doi-asserted-by":"publisher","DOI":"10.1186\/ar4281"},{"key":"c8","first-page":"w14341","volume":"146","author":"W\u00fcthrich H","year":"2016","journal-title":"Swiss Med Wkly"},{"key":"c9","doi-asserted-by":"publisher","DOI":"10.1136\/ard.48.9.737"},{"key":"c10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.1991.tb01374.x"},{"key":"c11","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208237"},{"key":"c12","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2016-209707"},{"key":"c13","doi-asserted-by":"crossref","first-page":"192","DOI":"10.1097\/BOR.0b013e3283438e13","volume":"23","author":"Singh JA","year":"2011","journal-title":"Curr Opin Rheumatol"},{"key":"c14","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"c15","doi-asserted-by":"publisher","DOI":"10.1002\/art.30649"},{"key":"c16","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2017-211574"},{"key":"c17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050373"},{"key":"c18","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.091462"},{"key":"c19","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa050373"},{"key":"c20","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.080814"},{"key":"c21","doi-asserted-by":"publisher","DOI":"10.1186\/ar2978"},{"key":"c22","first-page":"188","volume-title":"Rheumatology","volume":"48","author":"Schumacher HR Jr","year":"2009"},{"key":"c23","unstructured":"Fachinformation Adenuric\u00ae                         (Febuxostat). www.swissmedicinfo.ch; 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