Wednesday, 20 Nov 2019

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Night-time Gout Onset is Not Related to Alcohol or Purine Intake

Gout's often told tale of a nocturnal rapid onset and dramatic pain provoked by a bed sheet, is studied in detail by Choi and the Boston online gout study. This report shows that more than half the attacks occur late night and are unrelated to alcohol or purine intake.

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PANLAR Ultrasound Study Group: Recommendations On Imaging Modalities In Gout

Gout is a systemic inflammatory disease with high potential for joint damage due to erosive changes and MSU deposits resulting in disability and chronic pain. Prompt diagnosis and effective treatment are key to better long term outcomes and decreased disability.

T2T Lowers Mortality in Gout

A Spanish prospective cohort of active, uncontrolled gout patients were followed and showed that failure to reach a target serum uric acid (sUA) level of 6 mg/dl (0.36 mmol/L) or less was associated with a 2-3 fold increase in mortality.

Novel Inhibition of MSU Crystal Inflammation

Researchers from Washington State University have shown that inhibition of tumor growth factor-β (TGF-β)-activated kinase 1 (TAK1) can effectively downregulate inflammatory mediators and suppress inflammation caused by gout.

Monosodium urate (MSU) crystals directly activate the inflammasome to produce a plethora of pro-inflammatory cytokines, including interleukin-1β (IL-1β). 

Patients Prefer Nurse Led Care for their Gout

Despite the well known, well publicized treat-to-target (T2T) goal of a serum uric acid (SUA) level < 6 mg/dl, this goal is seldom achieved (< 40%) in clinical practice and patient adherence has been unacceptably low. A recent study shows that nurse-led care led to better outcomes in gout including patient acceptability, long-term adherence, and less flares.

Anakinra Use in Hospitalized Gout Patients

While the efficacy and safety of interleukin 1 (IL-1) inhibitors (e.g., anakinra) in the acute management of gout and pseudogout has been repeatedly shown, the cost efficacy of such biologic therapy has rendered it impractical for most. A new retrospective study has shown that IL-1 inhibitors may be effective and appropriate for some medically complex, hospitalized patients with acute gout or calcium pyrophosphate crystal arthritis.