Gout

Dr. Beth Wallace and colleagues at the University of Michigan surveyed a national sample of older adults (50–80 yrs) and found that 70% currently report experiencing joint pain and 60% reported being told by a health care professional that they have arthritis. 

Incidence of acute coronary syndrome (ACS) was significantly higher among gout patients than in the general Swedish population, researchers found, even when data were adjusted for common comorbidities.

Can we predict the bad outcomes? Like when ITP evolves into SLE; or when psoriasis will develop arthritis; or if Sjogren's will develop lymphoma? Let's dive in and review these journal reports and this past week's news from RheumNow.com.

Dr. Jack Cush discusses declining survival rates in the USA, FDA approvals of new COVID subvariant boosters and other odd and possibly true new research reports from the past week on RheumNow.com.

NICE (UK) has systematically reviewed current medical evidence and delivered a set of recommendations with consideration of cost effectiveness.

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow and discusses a case of refractory juvenile dermatomyositis with calcinosis.

In a cross-sectional study of US adults, gout was more prevalent in black adults compared to white adults; possibly explained by sex-specific dietary differences and social determinants of health and clinical factors. 

A large case-control study showed that gout patients who experienced a cardiovascular (CV) event were more likely to have had a recent (< 120 days) gout flare compared to those without CV events. This study sought to investigate the temporal association between gout flares and cardiovascular events in a gout cohort. 

Dr. Jack Cush reviews the news, journal reports and rheumatologist cases from the past week on RheumNow.com. This podcast is brought to you by StillsNow.com - be sure to sign up for our monthly StillsNow email and Monthly StillsNow Podcast.

Dr. Jack Cush reviews the new studies and drug approvals and new insights into febrile disorders from the past week on RheumNow.com Ustekinumab (IL-12/23i) phase 2 study was successful in #SLE; but the phase 3 LOTUS study of 512 pts, UST was NOT superior to PBO (SRI-4 44% v 56%) at 1 year. Study was halted for lack of efficacy (but no safety concerns). https://bit.ly/3RvPzDm

Horizon has announced that the U.S. Food and Drug Administration (FDA) has approved the expanded labeling of pegloticase (Krystexxa) injection to be co-administered with methotrexate (MTX), to improve response rates in patients with uncontrolled gout.

A study in the Annals of Internal Medicine reports chronic kidney disease (CKD) patients can be safely treated with allopurinol without an increased risk of mortality.

Despite updated gout management guidelines from European (EULAR) and British (BSR) societies, treatment of gout is suboptimal with regard to the use of urate-lowering therapy (ULT) and normalizing serum uric acid (< 6.0 mg/dl) levels.

Topical treatments have so often been the low level “sure you can try this” option. However there are exciting data that these approaches may become part of our main armamentarium. 

Urate lowering therapy (ULT) is the backbone therapy for long-term gout treatment and maintenance, but real-world gout management is often imperfect and suboptimal.