Management of Gout

To the Editor.— In the article "Management of Gout" (242:361, 1979) inThe Journal, little mention is made of the importance of colchicine in preventing attacks of gout. Most rheumatologists believe that patients who have gout should receive colchicine indefinitely to prevent attacks. In discussing the use of intravenous colchicine in treating acute attacks, the authors state that 2 mg is used, whereas 3 mg intravenously should be used (Wallace SL: The treatment of gout.Arthritis Rheum15:317-323, 1972). The authors do state that "prophylactic therapy with low-dose oral colchicine, 0.6 mg twice per day, may be helpful in any patient with a history of gout." There is no question that it is helpful and should be continued indefinitely. There are practically no patients who cannot tolerate low-dose colchicine therapy. The authors mention that the precipitation of acute gouty arthritis is the most common side effect of allopurinol therapy. This