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Treat-to-Target Works in Gout With No Cardiac Toxicity

ACR

New research presented this week at ACR Convergence, the American College of Rheumatology’s annual meeting, shows that allopurinol and febuxostat may effectively lower urate levels when used in a treat-to-target approach. Importantly, both urate-lowering therapies were very effective with 90% of patients reaching target urate levels. Additionally, both appeared safe, with no evidence of increased cardiovascular toxicity (Abstract #1900).

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Industry Abstract Previews #ACR21 - Horizon, Aurinia, AstraZeneca

Jack Cush, MD

The pharmaceutical companies will feature the results of their pivotal clinical trials and data analyses at ACR Convergence 2021.  Below is a listing of some of their best studies for you to review and look for in the meeting.

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RheumNow Podcast – #ACA: Ask Cush Anything (10.8.2021)

Jack Cush, MD

Arthritis numbers are rising, and people are finally talking about osteoarthritis. Also, ACR 2021 is just a few weeks away - are you ready? Finally, I'll review cases and questions submitted by viewers in Ask Cush Anything (#ACA). This, and nearly a dozen news items and reports, are discussed in this week's podcast. Let's begin.

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Prevalence of Arthritis Rising in the USA

MMWR

The latest CDC estimates of the national prevalence of arthritis and arthritis-attributable activity limitations (AAAL) show a continued increase in absolute number: 58.5 million (23.7%) U.S. adults have arthritis, 25.7 million (43.9%) of whom have AAAL. 

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Gout Flare and Treatment Studies Lacking in Severe Chronic Kidney Disease

Jack Cush, MD

Gout is a common comorbidity amongst those with chronic kidney disease (CKD), with the added challenge of choosing best therapies in the setting of declining renal function.  A systematic literature review notes significant deficiencies regarding the efficacy and safety outcom

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Starting Febuxostat During an Acute Gout Flare

Jack Cush, MD

A randomized controlled trial in gout patients has shown that starting febuxostat during an acute gout flare was without ill-effects and did not prolong the gouty attack.

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RheumNow Podcast – I Wanna New Drug.V2 (9.24.2021)

Jack Cush, MD

Almost three years ago to the day, I did a podcast entitled, "I wanna new drug." As I go over this week's podcast, I want to say it again. I want a new drug safe enough to use during pregnancy, for PMR, for GVHD, and more. I'm going to cover these, and other topics including lupus, COVID breakthrough infections, and statin use and the risk of RA, as I review the news and journal articles from the past week on RheumNow.

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8M415 Gout Imaging Advances: Ralf Thiele on US🔊and DECT US>DECT: DECT needs a minimal density of MSU; DCS, tophi <2mm, liquid tophi may not be detected; US can show hyperemia DECT>US: DECT can show areas that may be overlooked from standard protocols 💡Bonus:stay around for Q&A https://t.co/G7yQaj9fHw
USSONAR USSONAR_Rh ( View Tweet)
Dr Stewart @TonyMerriman2 report in 16,000 patients that repeat serum urate testing not superior to single measure in predicting incident gout over 9 years. Makes sense in general, maybe different in those with medication changes etc? Abstr#1449 #ACR21 @RheumNow https://t.co/69NofMNuB8
Richard Conway RichardPAConway ( View Tweet)
Rush on over to ‘DASH’ diet to ⬇️women at risk for gout abst#0991 #ACR21 @RheumNow it is low salt diet and ⤵️serum urate and HTN https://t.co/smQgVpV3BD
Janet Pope Janetbirdope ( View Tweet)
In general low health literacy has ⬆️association with non adherence in chronic disease Rx including gout prevention but many other reasons for non adherence cross the health literacy divide. Ex use of alternative Rx, denial, side effects, advice from non HCPs #ACR21 @RheumNow https://t.co/mIIndW1FnV

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Janet Pope Janetbirdope ( View Tweet)

#ACR21 Rheum Secrets and Pearls Is it Allopurinol or adherence concern? Oxypurinol can be helpful in measuring adherence! Kolfenbach: "I despise the term non-compliant patient." Address the many reasons why adherence may be low! Health literacy is key. @Rheumnow https://t.co/CPJ8kvqcCm
Eric Dein ericdeinmd ( View Tweet)
DECT (dual energy CT) very helpful to distinguish gout from other crystals and give volumetric measurements using color-coded images... So do we need to do arthrocentesis to diagnose gout anymore? #ACR21 https://t.co/kn2IpXP870
TheDaoIndex KDAO2011 ( View Tweet)
Pearls on gout: 👉Gouty tophi can appear in the L spine and destroy the facet joints #ACR21 Radiology Bootcamp with Dr. Brindle. https://t.co/ml2uI9f10v
TheDaoIndex KDAO2011 ( View Tweet)
Erosive polyarticular chronic tophaceous gout Regional Winner of East Asia and Pacific Image Competition: Rheum Dz in Patients of Color #ACR21 @rheumnow https://t.co/1wrNAhjsw6
TheDaoIndex KDAO2011 ( View Tweet)
Primary care docs: please remember that it is not enough just to treat the acute gouty episode. This truly is a chronic debilitating disease #MedEd #gout https://t.co/lXTIqZXA1m

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Yousaf Ali MD yousafali_md ( View Tweet)

Beautiful, isn’t it? https://t.co/Ga0840KBcW

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Alla Ayten alla_ajten ( View Tweet)

Diagnositic Imaging comparison in 36 acute Gout vs CPPD pts: - Better: MSK US sensitivity/specificity for gout 92%/83% & 91%/92% for CPPD - Less: DECT sensitivity/specificity for gout 63%/92% & 55%/92% for acute CPPD https://t.co/Ee2MFb8qyl

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Dr. John Cush RheumNow ( View Tweet)

ASK CUSH ANYTHING! Rheums: Have a question for Dr. Cush? Record it here and we may feature it on an upcoming podcast. #RheumNow https://t.co/wzNmOzH4VE https://t.co/KzPzWpSoW1

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Dr. John Cush RheumNow ( View Tweet)

The #1 question I get from new consults: “How did I get arthritis?” Here is my list of 11 drugs (or drug classes) known to cause arthritis or rheumatic disorders (as an unintended consequence). #RheumNow https://t.co/GsV0Qj9ENr https://t.co/IrTkY5yFdY

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Dr. John Cush RheumNow ( View Tweet)
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