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Allopurinol Use Does Not Increase Mortality in Gout with Chronic Kidney Disease

Jack Cush, MD

A population based trial has shown that allopurinol use dose escalation and achieving target uric acid levels (with allopurinol), was not associated with increased mortality in patients with gout and concurrent CKD

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Male vs. Female Responders (4.15.2022)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal Reports from the past week on RheumNow.com - including fellowship COVID-19 concerns, the limits of T2T in gout and the real odds of RA remission with your first biologic. 

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No Benefit to More Intensive Urate Lowering in Gout

Jack Cush, MD

While treat-to-target (T2T) is commonly advocated in gout management, it is unknown if T2T (or more intensive T2T) may result in less bony erosions in gout.

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Comorbidity Drives Risk of Death in Gout Patients

Jack Cush, MD

A study of men with gout from the US Veteran’s Health Administration (VHA) shows that excess mortality in gout could be attributed to comorbidities.

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Consequences of TNF inhibition (3.18.2022)

Jack Cush, MD

This week we're going to talk about the downside of TNF inhibitors, a few interesting observations in gout, and yes, kids do get COVID. We're also going to preview what's coming in April (hint: it's about PsA). This and more as Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

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Disappointment Behind Acute Gout Hospitalizations

Jack Cush, MD

Analysis of emergency department visits from two UK hospitals shows a high rate of hospitalization, and low use of urate-lowering therapies (ULT) and treat-to-target (T2T) management. 

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Ethnic and Behavioral Drivers of Gout Risk

Jack Cush, MD

Gout is common but disproportionately affects certain groups (e.g., the elderly, Pacific Islander, Blacks). Ethnic links to gouts were also shown to be linked to modifiable behavioral factors and such information maybe useful in managing gout patients.

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Low COVID-19 Vaccine Risks in Rheumatic Patients

Jack Cush, MD

Data from the European Alliance of Associations for Rheumatology Coronavirus Vaccine registry shows that patients with with inflammatory or noninflammatory rheumatic and musculoskeletal disease have similar adverse event rates as the general public.

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There is 1.4 million transgender persons in the US. ACP has published a guideline "Care of the Transgender Patient" addressing health disparities, certain cancers, substance abuse, mental health conditions, infections, and chronic diseases. https://t.co/AoBeOzv9YH https://t.co/jKabVELPxH

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COVID-19 Vaccination Uptake and Perceptions in Rheumatic Patients Putman et al has reported vaccine survey results from the C19-GRA in Lancet Rheumatology showing the uptake and vaccine hesitancy among people with rheumatic diseases (RMD). https://t.co/sqsOHGThzV https://t.co/zeZrlDeQ9Z

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2 studies from NKF meeting shows gout occurs in 13.5% of CKD on dialysis; and seen in 17-28% of Stg 3,4 CKD pts. CKD w/ Gout has more bone/mineral Dz (40 vs 26%), CHF (21 vs 14%), DJD (17 vs 9%); >1/3 NOT on urate lowering therapy https://t.co/sn40xqxRyg https://t.co/ewb0tpWukw

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No Benefit to More Intensive Urate Lowering in Gout While treat-to-target (T2T) is commonly advocated in gout management, it is unknown if T2T (or more intensive T2T) may result in less bony erosions in gout. https://t.co/uag4fJ4FSi https://t.co/djniwFl491

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211 pts presenting w/ hot swollen joint to the ER; 28 w/ septic arthritis; pseudogout 32; gout 50; & others: 101. Predictors of Septic Arthritis: RA (OR 3.4); skin infx (OR 3.3); liver Dz (OR 9.9); knee involv (OR 3.5); immunosuppressive use (OR 3.5) https://t.co/uASovNVOWb https://t.co/Fq3obVDavm

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Japanese study using Mendelian randomization (MR) analysis of the association between coffee consumption, gout & uric acid levels - showing coffee consumption can causally reduce gout risk (OR = 0.50), independent of SUA levels https://t.co/ymovYj5y40 https://t.co/uI7OqY9FcU

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Ask Cush Anything! Have a rheumatology question or case for Dr. Cush? Submit it here and we may feature it on an upcoming podcast. https://t.co/KgPIeScthr https://t.co/nk4re9mlcH

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Gout is common but disproportionately affects certain groups (e.g., the elderly, Pacific Islander, Blacks). Ethnic links to gout were also recently shown to be linked to modifiable behavioral factors that may prove useful in managing gout patients. https://t.co/uvIuw3zFnq https://t.co/EZomBGQIyt

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Dr. John Cush RheumNow ( View Tweet)
An odd association - Swedish Registry analysis matched incident gout (1:5) w/ non-gout & looked for birth associations. Future gout risk was assoc w/ maternal diabetes ( https://t.co/Tsz72SeTC8 3.1), congenital malformation (OR 1.33), $ small gestational (OR 1.75) https://t.co/r9dGMzBopK

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Polarized microscopy of synovial fluid to identify uric acid crystals was shown to high utility and reliability in a study of 5 rheumatologists (4 consultants, 1 registrar). 50 SF samples - good agreement w/ κ = 0.71 for MSU, 0.88 for CPP https://t.co/5c7N7spc0t https://t.co/9wXsHuCY6D

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Taiwan study of 12,786 pre-dialysis advanced CKD patients with gout shows that use of febuxostat or allopurinol was assoc w/ a reduced sepsis/infection risk - most w/ FEB (HR, 0.68; 0.52–0.87), but no signif difference in MACE or CVA https://t.co/zp7JLwzah8

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UK Biobank case control study of 15 871 pts with Gout and COVID. Gout associated with diagnosis of COVID-19 (OR 1·20; CI 1·11–1·29) but not with risk of COVID-19-related death in the cohort of patients diagnosed with COVID-19 (1·20, 0·96–1·51). https://t.co/dN5YnIqhzD

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