ACR Convergence 2020—In May 2020, the ACR published its updated guideline for the management of gout.1 It followed on the heels of a 2017 gout guideline published by the American College of Physicians.2 Although the guidelines provide similar recommendations on the treatment of acute gout, they differ importantly in the use of uric acid-lowering therapy…
ACR CONVERGENCE 2020—The results of a post-authorization study comparing the cardiovascular safety of febuxostat vs. allopurinol were presented in a late-breaking abstract session at the ACR’s fully virtual annual meeting on Monday, Nov. 9. Cardiologist Thomas MacDonald, MD, FRCP, MBChB, clinical professor (teaching and research) of molecular and clinical medicine, University of Dundee School of…
Acute gout can be very painful, causing patients to seek treatment in the emergency department. A retrospective study of pain interventions for gout in Rhode Island found that nearly 30% of patients received prescriptions for opioid medications over 30 months. Of these prescriptions, over 80% were for patients who had never been exposed to opioids…
The umbrella term crystalline disease covers arthritic conditions caused by deposition of crystals and associated inflammatory response, including erythema, edema and intense pain. The two most common crystal-induced arthropathies are gout, an arthritis secondary to inflammation caused by the presence of monosodium urate (MSU) crystals formed through high levels of serum urate, and calcium pyrophosphate…
In May, the ACR released a new treatment guideline for the management of gout for simultaneous publication in Arthritis & Rheumatology and Arthritis Care & Research.1 Based on evidence from more than 130 published studies, the guideline makes a total of 42 recommendations—of which 16 are strong: It has 27 recommendations for urate-lowering therapy (ULT)…
Patients with uncontrolled gout may benefit from a combination of pegloticase and methotrexate therapy, according to a small, retrospective study…
Monosodium urate (MSU) crystal formation, deposition and gout flares frequently affect joints that have been damaged or are affected by osteoarthritis. These researchers examined the effects of human cartilage homogenates on MSU crystallization and MSU crystal-induced inflammation…
ATLANTA—The authors of the new draft ACR treatment guideline for the management of gout presented the draft guideline on Nov. 13 at the 2019 ACR/ARP Annual Meeting. Based on evidence from more than 130 published studies, there are 42 recommendations, of which 16 were strong, including 27 for urate-lowering therapy (ULT) management, 13 of which…
Case Presentation A 45-year-old man with crystal-proven gout, poorly controlled diabetes and chronic kidney disease was lost to follow-up for six years and presented back to the VA clinic in the midst of a gout flare. He stated he had continued taking 100 mg of allopurinol daily, but his serum urate level was 13.8 mg/dL….
Three clinical experts on gout offer their insights into common management errors, clinical pearls, new safety data from the FDA and the role of biologic therapies in the management of gout.