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Genes and Obesity Tied to Higher Gout Risk in Women
Excess adiposity and genetic predisposition both contributed to risk of gout among U.S. women, with the risks being highest when both factors are present, a large prospective study found.
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Day 4 Report from ACR21
My favorite three presentations from day 4 (Tuesday) at ACR 2021 included the following.
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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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#ACR21 is complete--view all our RheumNow's coverage.
https://t.co/wkZ66lcB44
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Dr. John Cush RheumNow ( View Tweet)
Geriatric Rheumatology:Improving care of aging patients
Dr.Kathryn Dao ( @KDAO2011) moderates a panel w/ Drs.Una Makris, Katherine Wysham, Sebastian Sattui + Devyani Misra, as they discuss aspects of improving care of/outcomes for aging patients. #ACR21
https://t.co/lF3yUZBEkd https://t.co/hYufA8ptqj
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Dr. John Cush RheumNow ( View Tweet)
Data from ASN Kidney Wk 2021; US Renal Data System of 275,651 dialysis pts - 15% had gout Vs 85% without gout; Gout pts were older, more male, obese, had more hospitalizations (66 vs 57%), mortality, more CVD, PVD and MI https://t.co/m1d0SJEJjw
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Dr. John Cush RheumNow ( View Tweet)
Gout being sneaky🧐
Common consult question is "infection or flare?" in patients with gout.
@ACR21 ABS0467 w/ Dr Michael Toprover:
🔸Calibrating DECT for LS-spine in gout patients.
🔹DECT signal = MSU deposition?
🔸Future data on back pain/gout flare/MSU🤞?
@RheumaRepublic https://t.co/aDCusqBk8G
Bonnia Liu bonnialiu ( View Tweet)
Important #gout study (I'm biased): allopurinol is non-inferior to febuxostat with regards to gout flare when used in a T2T approach, with no differences in AEs, including CV risk. 99% achieved serum urate target over course of trial. Key slides following. #ACR21 https://t.co/tWeGvZ4rKY
Tuhina Neogi, MD, PhD Tuhina_Neogi ( View Tweet)
We may be getting a new urate lowering therapy. Tigulixostat is a non-purine selective xanthine oxidase inhibitor. Nothing worrying on safety. But I think febuxostat is probably more effective than this? Abstr#L05 #ACR21 @RheumNow https://t.co/Lg0slMlah2
Richard Conway RichardPAConway ( View Tweet)
Advantages of treat to target (of serum urate) beyond less gout flares? Maybe equal to ⬇️MACE events - I hope in long term less MACE due to less ⬆️CRP w flares. Modelling observational study abst#L06 #ACR21 #ACRBest @RheumNow below is comparative safety T2T better than usual care https://t.co/95M6lNX416
Janet Pope Janetbirdope ( View Tweet)
#ACR21 L05. Tigulixostat - non-purine selective XO inhibitor for gout
⭐️Effectively brought down serum uric acid <5, dose-dependent
⭐️10% pts gout flare with urate lowering
@Rheumnow https://t.co/LgwkAQ1wg8 https://t.co/G8CxdGcVOQ
Links:
Eric Dein ericdeinmd ( View Tweet)
#ACR21 L06 Comparative Safety of Gout "Treat-to-target" and "Usual Care" Treatment Strategies on Cardiovascular Outcomes Using Observational Data: Causal Inference Approach https://t.co/4qo49lpBrt Video interview (https://t.co/k8PHCPaF1r) https://t.co/D4G2Ylkelm
Links:
Kazuki Yoshida kaz_yos ( View Tweet)
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
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)
