In a dose-finding, clinical trial, Terkeltaub et al. examined the safety and efficacy of tigulixostat, a nonpurine xanthine oxidase inhibitor, for lowering the serum urate levels of patients with gout and hyperuricemia.
Point-of-Care Uric Acid Testing
In June 2022, I listened to several presentations on gout at EULAR’s European Congress of Rheumatology. Most began with data confirming a sad truth that we, as rheumatology providers, are all aware of: too many patients are taking subtherapeutic doses of urate-lowering therapy (ULT).1,2 Recommendations from the American College of Physicians in 2017 advocated for…
3 AC&R Study Summaries: Treat to Target in Gout, Response to Biologics in Patients with JIA, & Rehabilitation Dose in Adults with RA
Treat to Target in Gout Monitoring & achievement of target serum urate levels By Jing Li & Gabriela Schmajuk, MD, MS Why was this study done? The ACR’s 2020 guideline for the management of gout recommends using a treat-to-target (T2T) approach to lower serum urate (SU). Using the ACR’s RISE registry, we examined the use…
Gout & Excess Risk of Severe SARS-CoV-2 Infection
In this large, population-based study, Xie et al. found that the risks of SARS-CoV-2 infection, 30-day hospitalization and 30-day death were higher among individuals with gout than individuals without gout in the general population, irrespective of COVID-19 vaccination status.
Pseudo-What? Exploring the Classification Criteria Development Process for CPPD
PHILADELPHIA—The term pseudogout has been a source of confusion among rheumatologists, especially as our understanding of calcium pyrophosphate crystal deposition (CPPD) disease has become more nuanced. This condition has many complex and interesting facets that warrant closer investigation. An ACR Convergence 2022 session sought to update the audience on the progress to date in developing…
Rheumatic Disease Research in Indigenous Populations
This ACR Convergence 2022 session focused on ways to improve health equity in Indigenous populations.
Considering Benzbromarone as First-Line Therapy for Gout
In this comparative effectiveness clinical trial, Yan et al. set out to compare nontitrated, low-dose benzbromarone (not approved in the U.S.), a renal urate transporter 1 inhibitor, with low-dose febuxostat as the first-line therapy in gout patients with renal uric acid underexcretion.
Is Gout an Autoinflammatory Syndrome After All?
PHILADELPHIA—The term autoinflammatory syndrome was coined by Daniel L. Kastner, MD, PhD, National Institutes of Health (NIH), Bethesda, Md., not long after he discovered that mutations in the gene MEFV, which codes for the protein pyrin, are responsible for familial Mediterranean fever (FMF).1 Early on, the term was meant to signify monogenic conditions in which…
Image Case Report: Milk of Urate Bulla
A 60-year-old Black woman with a history of stage 3 chronic kidney disease, type 2 diabetes and hypertension presented with a 12-month history of asymmetric polyarthritis of the wrists, metacarpophalangeal (MCP), proximal interphalangeal (PIP), metatarsophalangeal (MTP) and knee joints. The review of systems was unremarkable. She denied oral ulcers, rashes, alopecia, or a history of…
Understanding the Role of Uric Acid in Gout
From the first substantial argument in the 19th century that uric acid played a role in gout, it took about 100 years for the medical community to accept its role in triggering acute inflammatory gout attacks. Two papers, both published in 1962, helped demonstrate the link between uric acid and acute gout attacks, quickly opening…
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