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Gout | More than Flares

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ACR: Medicare Cuts for Physicians Highlight Need for Reform

ACR

The American College of Rheumatology (ACR) was disappointed that the proposed Medicare Physician Fee Schedule (MPFS) from the Centers for Medicare & Medicaid Services (CMS) once again included a serious cut to the conversion factor.

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The Marriage between Gout and the Kidney

While the link between uric acid and gout was first described by Alfred Baring Garrod in the 1800s, the proof that uric acid might actually be the cause had to await the self-experimentation of two rheumatologists from the University of Pennsylvania. Given some comments that the presence of urate crystals in synovial fluid might just be a bystander phenomenon, they decided to inject monosodium urate crystals in one knee and water in the

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Gout Imaging in Care Gout is all about the crystals and the consequences of the disease are due to the inflammation they cause. Getting rid of urate crystals is the ultimate goal in gout, as we now know that it leads to the risk zero of flares and it normalizes the https://t.co/DGuiTOtQFa
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Saliva and Uric Acid Testing A recent report from China reaffirms the potential utility of salivary uric acid (UA) testing delivers smartphone-guided, enzyme-free gout screening at home for pennies per test. https://t.co/VtvJuPNEWA https://t.co/pdBmy5JoQd
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Gout is under-diagnosed & under-treated gout in women, Asians, Blacks, CKD Stages 3–5, elderly, transplant recipients, and Rheum patients on calcineurin inhibitors. For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/XWal7tB13k
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Four Things About Allopurinol Hypersensitivity Syndrome Dr. Robert Terkeltaub discusses allopurinol hypersensitivity syndrome in gout patients. https://t.co/5seiyfVLW1 https://t.co/0A1Rtk9hzS
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Systemic sclerosis metanalysis of 31 studies (32,134 pts) shows malignancy risk signif increased (SIR 1.66; CI 1.32 - 2.08). Highest: esophageal, liver, cervical, lung, & Heme (SIR 3.35 - 13.95). 7.4 yr mean from SSc to CA dx. https://t.co/IhxvfkMqkf https://t.co/qvxKgvBzWu
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Genicular artery embolization for knee OA does not work in a 12-mos randomized sham-controlled trial of 58 pts. Pain scores improved equally in both groups https://t.co/7wwmzpTaNL https://t.co/8MsRXqKDo2
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ACP Position Paper on Dietary Supplements

More than half of U.S. adults use dietary supplements, yet only a quarter use supplements recommended by a healthcare professional, and current law lets supplements reach the market with no premarket safety evaluation, unlike drugs or food additives.

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Gout in Minority Populations

Gout is the most common inflammatory arthritis, but its burden is not shared equally across populations. Recent research has revealed substantial racial and ethnic disparities in both who develops gout and the care patients receive. These differences reflect not only genetic susceptibility but also the substantial influence of social determinants of health, healthcare access, and environmental exposures.

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ARTIC trial enrolled 234 DMARD naive RA (<2yrs) pts; 15.4% (36) were seronegative (SNRA). @enrollment SNRA worse than SPRA(+) w/ higher SJC (17 vs 8, p<0.001), DAS28 (3.9 vs 3.4, p=0.03), US scores (55 vs 25, p<0.001), MD global (49 vs 39, p=0.006). No diff in Sharp score, https://t.co/xDxQKY8ZG2
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Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
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Glucocorticoid use in 1st yr of 574 newly DX RA cases-- 75% recv GC in 1st yr; 313 (55%) Rx at 1st visit. (m GC dose =9.3 mg/day. 1/2 (47%) recv IA GC injx. 20% had 1st yr infx. Risk of infx was NS (RR 1.13; 0.77 to 1.67) for 0-10 mg/d vs no GC https://t.co/s9YaGZsUjr https://t.co/ESHvVK1Egx
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Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/Go51MUOQlG
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Congratulations to Dr. Chandra Mohan and Univ. of Houston for receiving a $4 million NIH grant for a 10-year longitudinal study to identify the earliest biological triggers of autoimmune disease https://t.co/6kMcv9PD5r https://t.co/CsY8QAxrXR
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Hip Replacement Advances

Hip replacement surgery has been a major advance in the management of patients with hip damage and diminishing quality of life.  While this review provides new information regarding a new type of hardware (end of article), lets begin with a general overview.

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Retrospective study 1420 newly Dx non-tuberculous mycobacterial (NTM) infx (2012-2024) - 66 (4.6%) Dx w/ RA (55 after RA dx). Having RA + NTM incr risk of Resp. death (HR 4.3) w/ lower 5yr survival (75% vs 93%) partly explained by ILD and sytemic inflamm. https://t.co/6sdR7XwwD7
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In 2010 Colchicine fell under patent protection and price increased 16 fold, & out-of-pocket price increased 4.4-fold, colchicine use decreased 27%, while allopurinol, steroid & gout visits (ER, Rheum) increased. https://t.co/xyOxsnoM5z https://t.co/yoXehV0mPa
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CAR-T Therapy: EULAR 2026 Conference Recap https://t.co/XALrMFReOe https://t.co/TK0ot8MZb6
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