Evaluation of uricosuric agents in chronic gout.

Experience gained during the past 7 years with the prolonged administration of probenecid (Pascale, Dubin, and Hoffman, 1952; Talbott, 1953; Gutman and Yu, 1955; Bartels, 1955; Bauer and Singh, 1957) or of salicylates (Marson, 1953, 1954, 1955) has shown that continuous therapy with a uricosuric agent in effective doses, is the only practical method at present available for preventing the complications and morbidity which occur in patients with chronic gout. Subjective and objective improvement have been recorded in nearly all instances where there has been strict adherence to the therapeutic regimen. Attacks of acute gouty arthritis become progressively less frequent and less severe or may cease entirely; chronic joint pain and stiffness gradually improve; and tophaceous urate deposits gradually shrink in size or may be observed to disappear entirely (Yu and Gutman, 1951; Marson, 1952). The long-term treatment has been directed mainly toward the correction of the hyperuricaemia and reduction of the greatly increased miscible pool of uric acid shown to be present in most patients with established chronic gout (Benedict, Forsham, Roche, Soloway, and Stetten, 1950; Bishop, Rand, and Talbott, 1951; Talbott, 1953; Gutman and Yu, 1955). Although a diet restricted in purines and fat will lower the serum uric acid slightly (Marson, 1953; Gutman and Y%, 1955), dietary restrictions have been only partially successful as a treatment measure (Bauer and Klemperer, 1944; Talbott, 1953; Gutman and Yu, 1955). Practical experience has shown that the correction of the hyperuricaemia and the associated positive urate balance can most readily be accomplished by the administration of