The 2020 ACR Guideline for the Management of Gout is intended to provide guidance for the management of patients with gout, and includes recommendations on the indications for and optimal use of urate-lowering therapy (ULT), treatment of gout flares, and lifestyle and other medication recommendations.1 The guideline includes 42 recommendations, of which 16 are strong….
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Clinical Insights into Gout Management: Q&A with Dr. Tuhina Neogi
Gout affects more than 9.2 million adults in the U.S. and is the most common form of inflammatory arthritis. This condition and its complications are painful and potentially disabling with varying risk factors. It is characterized by symptoms that are usually sudden, with intense episodes of painful swelling in one or more joints, most often…

Highlights from ACR Convergence’s Late-Breaking Abstracts
COVID-19 vaccination, treatments for rheumatic disease and more—the Late-Breaking Abstracts session of ACR Convergence 2021 highlighted six studies with implications for rheumatology.

Tigulixostat Appears Promising for the Treatment of Gout
In a phase 2 study, tigulixostat treatment proved safe for lowering serum uric acid (sUA) levels in patients with gout.

FDA Approves Secukinumab for Children with Enthesitis-Related Arthritis & PsA
The FDA has approved the use of secukinumab for pediatric patients with enthesitis-related arthritis and psoriatic arthritis, after research showed a longer time to disease flare than placebo.

Study: Pegloticase & Methotrexate Co-Treatment Helps Uncontrolled Gout
A larger proportion of patients with gout had a therapeutic response at six months when treated with methotrexate and pegloticase than with pegloticase alone, according to results from the multi-center, open-label MIRROR (methoÂtrexate to increase response rates in patients with uncontrolled gout receiving KRYSTEXXA) study, recently published in the Journal of Rheumatology.1 The MIRROR study…
COVID-19 Vaccination in Patients with Rheumatic Disease
In January A&R, Simon et al. report a study to assess humoral and cellular immune responses after infection with, or vaccination against, SARS-CoV-2 in patients with B cell depletion and controls who are B cell competent, finding that B cell depletion completely blocks humoral but not T cell SARS-CoV-2 vaccination response. In the same issue, Connolly et al. evaluated disease flare and post-vaccination reactions in patients with rheumatic and musculoskeletal diseases following messenger RNA (mRNA) vaccination.

Case Report: Elevated Inflammatory Markers & a Hypermetabolic Mass
Consulting rheumatologists often assess patients with atypical clinical presentations for the possibility of an underlying rheumatic disease. Inflammatory syndromes that are not clearly rheumatic in nature can be particularly challenging to diagnose. Here, we share the case of a young woman with a long-standing undiagnosed illness and highly elevated inflammatory markers, and describe the evaluation…

Vax Hesitancy? Myths & Facts for Patients
Although more than 189,300,000 eligible Americans are fully vaccinated against SARS-CoV-2 as of Oct. 18, 2021, vaccine hesitancy persists.1 The U.S. Centers for Disease Control and Prevention (CDC), citing data from the U.S. Census Bureau’s Household Pulse Survey collected between May 26 and June 7, 2021, reports that in some U.S. counties—particularly in the Southeast…

Rheumatic Complications from Immune Checkpoint Inhibitors
Immune checkpoint inhibitors (ICIs), such as anti-programmed cell-death 1/programmed death-ligand 1 (anti-PD-1/PD-L1) or anti-CTL-associated protein (anti-CTLA-4), have dramatically changed the treatment of advanced cancers over the past decade. ICIs block T cell inhibition, thus increasing the anti-tumor immune response. ICIs are used not only for metastatic cancer, but also as adjuvant treatment for some stage…
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