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Benefit of Achieving Target Serum Urate Levels in Gout with Chronic Kidney Disease

Jack Cush, MD

A cohort study of gout patients with CKD stage 3 found that lowering serum urate (SUA) level to less than 6 mg/dL, lowered the risk for severe or end-stage kidney disease progression.

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ICYMI: VITAL Info on Autoimmune Disease (2.9.2024)

Jack Cush, MD

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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Sedentary Behavior Increases the Risk of Gout

Jack Cush, MD

NHANES national survey study shows that sedentary behavior is an independent risk factor for gout, especially in those without hyperuricemia. 

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Best of 2024: Determinants of Gout Flares

Jack Cush, MD

Approximately 12 million US adults in the US have gout. Two recent literature reports in JAMA and Arthritis Care & Research highlight contributors to gout flares.

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Don’t Buy Guitars (12.6.2024)

Jack Cush, MD

This year at ACR24, the RheumNow faculty and reporters were prolific, generating >800 Tweets, 56 written articles, 117 Videos and 28 podcasts – all in 4 days! You can best review and learn ACR24 by A) Rheumatology Roundup; b) Topic Panel videos; and c) Topic podcasts.

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ACR 2024 - Day 1 Report

Jack Cush, MD

ACR Convergence 2024 opened today with a full slate of presentations, posters and specialty meetings.  The meeting began with a flip: the plenary sessions started at 9AM and the poster session began at 1030 AM. Below are some of the highlights from day one in Washington, DC.

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Benefit of Achieving Target Serum Urate Levels in Gout with Chronic Kidney Disease A cohort study of gout patients with CKD stage 3 found that lowering serum urate (SUA) level to less than 6 mg/dL, lowered the risk for severe or end-stage kidney disease progression.… https://t.co/NsGUGvb5L5 https://t.co/QPBWA4VqTo
Dr. John Cush RheumNow ( View Tweet)
12 mos study of RCT 179 gout pts starting allopurinol finds that betw mos 6-12, gout flares went down. 38% had no flares, 19% had 1 flare, & 43% had >1 flare in 2nd 6 mos. # flares equates to control and impact of gout on outcomes. https://t.co/TMwXZStbJU

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Dr. John Cush RheumNow ( View Tweet)

Sedentary Behavior Increases the Risk of Gout NHANES national survey study shows that sedentary behavior is an independent risk factor for gout, especially in those without hyperuricemia. https://t.co/LDhK3iDnrS https://t.co/z6I6tRw9Fr

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Dr. John Cush RheumNow ( View Tweet)
#ACR24 Year in Review: 💡GLP1i significantly decreased knee OA pain over time (or was it the wt loss itself?🤨) 💡CD19 CAR T-Cell therapy has potential to treat/cure many autoimmune diseases (are risks and $ worth the benefit?) 💡 High risk of CV events within 30 days of gout… https://t.co/g3egOpCYNr https://t.co/KMiOEP7pSg
Dr. John Cush RheumNow ( View Tweet)
Biomarker Study of 171 synovial fluid samples (54 primary OA, 57 RA, 30 Crystal,30 septic arthritis) examined the cartilage oligomeric matrix protein (COMP) to IL-8 ratio and found it can differentiate primary OA and inflamm arthritis w/ sensitivity 87% and specificity 89%… https://t.co/UH77DFgAlJ https://t.co/MfXQcl0BhW
Dr. John Cush RheumNow ( View Tweet)
Lancet forecasts that in Australia 5.4 million will have arthritis 2040, a 31% increase 4.1 mill in 2025. Included 3.2 w/ OA, ~750K w/ RA, & 8500 w/ JIA. OA incr in males from 6.3% to 7% (2040). & 10.8 to 12.2% in F. RA will grow from 1.56 to 1.75% in males and 2.6 to 2.9% in… https://t.co/6DM0ZLlZ05 https://t.co/djPP1cUDOI
Dr. John Cush RheumNow ( View Tweet)
Study of 16,598 CAD pts showed in pts w/ normal hsCRP<2mg/L, increasing SUA didnt predict CV/MACE events. But if the hsCRP≥2 mg/L, increasing urate(SUA)was signif. assoc w/ increased MACE. Each 1mg incr in SUA yielded an 11% increase in MACE (adj p < 0.001)… https://t.co/9ehtOcoeBK https://t.co/t9IWQ8WUvY
Dr. John Cush RheumNow ( View Tweet)
Mitochondria: the powerhouse of the cell—but the fuel behind gout flares? #ACR24 @RheumNow https://t.co/lV4dovLV18

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Akhil Sood MD AkhilSoodMD ( View Tweet)

Wang et al. Propensity score matched cohort study. 63,302 individuals. Colchicine associated lower risk of THR/TKR, HR 0.87. @RheumNow #ACR24 Abstr#2557 https://t.co/UUU3Tm67ML https://t.co/uKi0e8E7HV

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Richard Conway RichardPAConway ( View Tweet)
#Gout attack is assoc w 1.5 X MI, MACE in next 30 days @ACRheum @RheumNow #ACR24 https://t.co/7IeFbW6xW8

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Janet Pope Janetbirdope ( View Tweet)

This is very true. We showed a number of years ago that patients with gout have increased platelet activation at baseline, which then dramatically increases during flare. Treating gout properly may ameliorate this. #ACR24 @RheumNow https://t.co/VL8fy3ezjx https://t.co/9XdrG1NG9c

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Richard Conway RichardPAConway ( View Tweet)

Challener et al. TriNetX study. 32,000 patients. SGLT2i reduce need for gout visits (HR 0.94) ULT initiation (HR 0.69) and colchicine (HR 0.82). I worry about the discordant rates, ULT initiation much lower. @RheumNow #ACR24 Abstr#0848 https://t.co/VTKHMmDEKV https://t.co/C2opiDmBXx

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Richard Conway RichardPAConway ( View Tweet)
📈 Data from @UIowa_Rheum on how rurality impacts delay to diagnosis in #GCA 📍 0747 👉🏼 People living in more rural areas have an increased time to diagnosis & treatment- further prospective studies needed to delineate effects of rurality further @RheumNow #ACR24 @LemonReneeNi https://t.co/3YMcI9ha3T

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Mrinalini Dey DrMiniDey ( View Tweet)
Yokose et al. Population study using NHANES. Gout patients had 1.6 higher fold risk of gallstone disease. What? Why do we care? Well, GLP-1s associated with higher risk gallstones also... @RheumNow #ACR24 Abstr#0133 https://t.co/nf4R0hQe50 https://t.co/wDrEDeNbpT

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Richard Conway RichardPAConway ( View Tweet)
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