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…
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…
Dalmatians have defects in the renal tubular reabsorption of filtered urate and the hepatic conversion of uric acid to allantoin that may provide unique insights into uric acid homeostasis, with implications for the treatment and management of gout.
New research examined the link between a reduction in serum uric acid (SUA) levels and the reduced risk of renal function decline in patients with gout. The findings suggest that aggressive serum acid-lowering approaches may be helpful in slowing the progression of renal disease…
Current guidelines for the long-term management of gout recommend a combination of lifestyle management and/or pharmacotherapy to lower serum UA levels to <6.0 mg/dL in most patients or <5.0 mg/dL in patients with more severe disease. Allopurinol is the most widely used xanthine oxidase inhibitor and is recommended in treatment guidelines as a first-line urate-lowering…
Serum uric acid (UA) is an important factor in the causal pathway for gout. It has also been implicated as a potential risk factor and/or mediator of cardiovascular disease outcomes and mortality in a large number of observational studies. Although many of the clinical trials targeting serum UA reduction have focused on pharmacologic interventions, diet…
(Reuters Health)—Obese people who have weight loss surgeries, such as gastric bypass, are much less likely than those who don’t have surgery to develop gout, a painful type of arthritis, according to a Swedish study. People who chose to get weight loss surgery are also less than half as likely to develop hyperuricemia, too much…
Be careful when prescribing allopurinol to black and Asian gout patients, a study newly advises. Black and Asian patients who take this ubiquitous, more-than-40-year-old medication are at much higher risk of certain serious skin reactions than are Caucasians or Hispanics. Compared with Caucasians, blacks who take allopurinol to lower blood urate levels have an increased…
When uric acid becomes elevated in the human body, a variety of problems can develop, most notably gout—a painful, inflammatory arthritis caused by uric acid crystal deposition in joints. Chronically elevated uric acid can also lead to painful kidney stones. The majority of patients found to have hyperuricemia, however, never go on to develop gout…
I read with interest the Diagnostic View (TR, April), which, according to the authors, represented a case of rhupus, an overlap syndrome of RA and SLE. I challenge this view. My arguments: In the case of erosive RA, typically erosive changes are seen at MTP joints other than MTP1 (e.g., MTP5). In addition, the erosive…