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Uricase-Targeted Therapies in Gout

Jack Cush, MD

In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based biologics are reserved for uncontrolled/refractory gout patients with gouty flares, active synovitis, and/or non-resolving tophi despite optimized oral ULT.

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When Gout Flares, So Does the Cardiovascular System

Edoardo Cipolletta, MD, PhD

We have spent decades teaching that a gout flare is a joint problem: a hot, swollen, painful joint that we treat with anti-inflammatory drugs and move on from (i.e., the treat to avoid symptoms strategy). The campaign title says it well — gout is more than flares.

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Chikungunya Club Meeting (7.24.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal reports from the past week on RheumNow.com.

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Evidence-Based Dietary Recommendations for Gout

Chio Yokose, MD, MSC

Gout, historically referred to as the “disease of kings,” was once associated with a lifestyle of excess, including ready access to alcohol and rich meats once reserved for society’s highest ranks.

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Myth vs reality

Persistence of education and monitoring is crucial to optimal gout management

N. Lawrence Edwards, MD, MACP, MACR

It is important that the misconceptions and myths held by the patient are discussed and dispelled and, most importantly, establish a clear understanding of “the plan” and the reason for initiating urate-lowering therapy (ULT).

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Chondrocalcinosis

Expert Perspective on Calcium Pyrophosphate Deposition Disease

Jack Cush, MD

A recent perspective by Tedeschi tackles many unresolved issues around CPPD diagnosis, classification, and management, including the lack of clinical trials or FDA approved treatments.

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Gout pills injection

Pragmatism in Gout: How therapeutic choices can have multiple benefits

Michael Toprover, MD

William James famously wrote in Pragmatism, “There can be no difference anywhere that doesn’t make a difference elsewhere.” Gout treatment offers a striking medical example of that idea.

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Calcium Pyrophosphate Deposition Dz new terminology from 2026 G-CAN consensus. Preferred: - acute CPP crystal arthritis - Chronic CPP crystal arthritis - Chronic CPP crystal arthritis - OA w/ CPP - Chondrocalcinosis (xray) * Pseudogout is obsolete https://t.co/L95N2ObHr3 https://t.co/ST7RkJa8BR

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UK primary care database (2000–21) gout study of new colchicine initiators (n 31,478) vs noninitiators (mean 60 yrs, BMI 30), follow-up of 4.5 yrs. Colchicine use had a signif. 12% lower risk of Joint Arthroplasty (HR 0.88); 23% lower TJA in knee/hip OA (HR 0.77) https://t.co/bT07lUYBB2
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QD Clinic: Gout, Sepsis… or Both? Dr. Mrinalini Dey, London, discusses a complex case. https://t.co/UtncfZgZyL https://t.co/xVTA0LnPpN

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"Leeuwenhoek (invented the microscope) examined uric acid (C5H4N4O3) crystals from gout patients and found them to resemble needles. He expounded on his observations in an 11 July 1679 letter responding to an earlier query from Mr. Lambert van Velthuysen (1622–1685), a physician, https://t.co/mY2wqYlRda
Dr. John Cush RheumNow ( View Tweet)
UK primary care database (2000–21) gout study of new colchicine initiators (n 31,478) vs noninitiators (mean 60 yrs, BMI 30), follow-up of 4.5 yrs. Colchicine use had a signif. 12% lower risk of Joint Arthroplasty (HR 0.88); 23% lower TJA in knee/hip OA (HR 0.77) https://t.co/TkYFYhANuH
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QD Clinic: Gout: Is it the Journey or the Destination? Dr. Arthur Kavanaugh discusses a gout patient whose frequent flares improved after lifestyle changes, despite medication not being enough on its own. https://t.co/frf4O87L0I https://t.co/cjtiYY9Ayt

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Predicting and Managing Gout Flares in Hospitalized Patients Dr. Kanon Jatuworapruk, Bangkok, discusses predicting and managing gout flares in hospitalized patients as part of RheumNow's "Gout: More than Flares" campaign in July 2026. https://t.co/wrLbjsayrI https://t.co/eWmRqPNWsJ

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Genetic study of 16 pts w/ Allopurinol-induced severe cutaneous adverse Rxn (SJS/TEN) shows 2 class I alleles to be associated: HLA-B*58:01 (OR, 28.0 [95% CI, 8.6-100.6]) and HLA-A*34:02 (OR, 20.6 [95% CI, 3.3-131.1]). Both explain 80% risk in US pts https://t.co/OxDXuWCbup https://t.co/oky61JImQV

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Seronegative RA Disease Activity (7.17.2026) Dr. Jack Cush reviews the news, journal articles and Gout features from this past week on RheumNow and check your knowledge in this week's RheumIQ quiz! https://t.co/e0u9qwtHVi https://t.co/oav00L7Lzw

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Gout patients are at greater risk for dementia, sleep apnea, septic arthritis and erectile dysfunction. For more gout content, follow our Gout: More than Flares campaign at https://t.co/lQoiFjubZJ, https://t.co/p4WQ1GCB68

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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 https://t.co/AWZbjaUtdu
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RHEUM SURVEY Q: Which gout drug has the greatest toxicity risk? Answer here>> https://t.co/EQrEjD9237

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SGLT2i use in gout reduces use of gout meds. Study of 26,739 gout pts w/ NIDDM (mean 66 yrs), 67% w/ polypharmacy. SGLT2i (vs DPP-4i) user had less Allopurinol starts (HR 0.62;0.52–0.73), also lower use of steroids (,78), NSAID (.85), colchicine (.87) & diuretics (.87) https://t.co/1dW27YzSvg
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