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19% Arthritis Prevalence in the USA
According to the National Health Interview Survey (NHIS), in 2022, the prevalence of diagnosed arthritis in adults was 18.9% (women 21.5%, more than men 16.1%). These numbers are down since the CDC's MMWR report of 2019–2021, where is was estimated 21.2% of U.S.
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EMR study identified 3.5+ million pts w/ BMI >30 -- 23% had sleep apnea (OSA). OSA had >2 fold risk of gout (7.2% vs 2.8%)vs those without OSA (p<0.0001). The odds of having gout are 2.65 times higher(HR 2.39; (CI) 2.367-2.419, p<0.0001). https://t.co/GgWrAiFPds https://t.co/QuQUk7nwDK
Dr. John Cush RheumNow ( View Tweet)
Excess Cardiovascular Risk in Gout
A UK population cohort study has shown that gout carries an increased risk for a wide variety of cardiovascular disorders.
https://t.co/ThDbAkI0VN https://t.co/uYz9Swu6sR
Dr. John Cush RheumNow ( View Tweet)
Excess Cardiovascular Risk in Gout
A UK population cohort study has shown that gout carries an increased risk for a wide variety of cardiovascular disorders.
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Serial plasma samples assayed for 92 inflammation-related proteins, during and after gout attacks. 21 were differentially expressed. Gout flares assoc w/ increased IL-6, CSF-1, VEGF-A & tumour necrosis factor superfamily 14 (TNFSF14 was highest) https://t.co/2p8vTFcmvD https://t.co/5z1gYdsKJO
Dr. John Cush RheumNow ( View Tweet)
UK Clinical Practice Research Datalink matched cohort study compared Gout (152K) to controls (709K) - CV devlopment higher in gout (21% vs 15%; HR 2.58). Moreso in women (HR 1.88). Gout pt had more CKD, HTN, obesity dyslipidaemia, & NIDDM https://t.co/BXCawnuIfa https://t.co/ZMuK9Msesb
Dr. John Cush RheumNow ( View Tweet)
Taiwan National Health claims data looked at drugs & gout flares. Signif increase flares were seen w/ ASA, thiazides, loop diuretics, ethambutol, pyrazinamide (1.15-3.35) & metformin (SR=1.14). Lower risk w/ fenofibrate (SR=0.60) & losartan (0.92) https://t.co/eBiiM83ei0 https://t.co/296XAbxwkc
Dr. John Cush RheumNow ( View Tweet)
Full read, review of COLCHICINE, a, w/ narrow therapeutic index, & assoc. w/ overdose & fatalities. Discuss Interactions, unauthorized access, overdoses, inappropriate dosing. No dose adjustments w/ Liver dz, but modest changes w/ severe CKD, dialysis https://t.co/53aOA4uqdY https://t.co/fuEwWsXMZG
Dr. John Cush RheumNow ( View Tweet)
Determinants of Gout Flares
Approximately 12 million US adults in the US have gout. Two recent literature reports highlight contributors to gout flares.
https://t.co/F2eiWXOTkF https://t.co/YFftaITmnQ
Dr. John Cush RheumNow ( View Tweet)
VITAL Info on Autoimmune Disease (2.9.2024)
Dr. Jack Cush reviews the journal reports from the past week on RheumNow.com. Highlights are summarized by three songs: "Stairway to Heaven", "You're No Good", and "How Long (has this been going on)".
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Determinants of Gout Flares
Approximately 12 million US adults in the US have gout. Two recent literature reports highlight contributors to gout flares.
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No evidence of harm starting urate lowering Tx (ULT) during #gout attack. Metanalysis 6 RCTs (445 pts) w/ gout attacks given ULT vs PBO or delayed ULT. No differences in pain, time to resolve gout flare or risk of recurrent gout flare in 30d (RR 1.06) https://t.co/Zk6OjJ8I2F https://t.co/prBQeSYH2Y
Dr. John Cush RheumNow ( View Tweet)
Remission in gout is 6 to 12 months with no flares.
Lisa Stamp.
#RNL2024
@RheumNow https://t.co/OlJK7HMNeX
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Role of anti- inflammatory prophylaxis when starting ULT in gout .
6 months. ? Longer period of prophylaxis or no prophylaxis?
Lisa Stamp
#RNL2024
@RheumNow https://t.co/sKKHWp9Ihw
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
Serum urate level and gout flare.
DECT images at baseline and target.
Lisa Stamp.
#RNL2024
@RheumNow https://t.co/z2PuoHnH2T
Nouf Al hemmadi NoufAhmedAlham2 ( View Tweet)
@RheumNow #ACR2024
"Lest we forget the flare" - Lisa Stamp
Studies are focused on uric acid levels, rather than flares - Less objective but more important to patients
Consider initiation/discontinuation of prophylaxis with urate lowering
T2T is only meaningful w ass. of flares
Eric Dein ericdeinmd ( View Tweet)
Dr Weber would add low dose #colchicine in pts who are at very high CV risk. Be careful with pts who have CKD #RNL2024 @rheumnow https://t.co/k00vqiQlI5
TheDaoIndex KDAO2011 ( View Tweet)
No evidence of harm starting urate lowering Tx (ULT) during #gout attack. Metanalysis 6 RCTs (445 pts) w/ gout attacks given ULT vs PBO or delayed ULT. No differences in pain, time to resolve gout flare or risk of recurrent gout flare in 30d (RR 1.06) https://t.co/xUX2U6MmGP https://t.co/2bV0g2FOSK
Dr. John Cush RheumNow ( View Tweet)
Experience the Future of Rheumatology at RheumNow Live 2024, just two weeks away!
Don't miss out – secure your spot today for an unforgettable journey into the latest advancements and insights.
https://t.co/bbnb97MOHO https://t.co/QXO34ZmP2i
Links:
Dr. John Cush RheumNow ( View Tweet)
2023 Rheumatology Year in Review
Dr. Jack Cush reviews highlights, advances and hot topics in rheumatology from 2023 and the RheumNow website.
2023 was a year of growth and new horizons while returning to operational and practice standards (in care and education) established before the pandemic.
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