Gout

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Rheum Drugs & IDSA Guidelines to Treat COVID-19

Jack Cush, MD
Dec 01, 2022

The Infectious Diseases Society of America has recently updated its recommendations with regards to the treatment of severely ill, hospitalized COVID-19 infected patients and also about the appropriate use of anti-IL-6, JAKs and colchicine.

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Methotrexate + pegloticase increases response rates in gout

Bella Mehta, MBBS, MS
Nov 15, 2022

In abstract 0001 presented at ACR22 Convergence, researchers presented 12-month data from a randomized double-blind placebo-controlled trial of pegloticase with or without MTX.

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GWAS analysis of 2.5m people (120k with gout) showing identifies 1486 candidate causal genes for gout. Looking at urate handling as well as disease propagation (eg. IL1/6). Widespread GWAS allowing us to investigate these diseases differently. @RheumNow #ACR22 #Plenary

Julian Segan @JulianSegan( View Tweet )

Nov 14, 2022
#ACR highlights - #pegloticase in #gout - less reactions and more benefit w #MTX MIRROR RCT. Better than no MTX. Will change my practice - if I can access to a #peguricase, I will Rx w concomitant MTX Abst#0001 #ACR22 @RheumNow

Janet Pope @Janetbirdope( View Tweet )

Nov 14, 2022
Venuturupalli et al. Elevated CASPASE 1 expression in synovial biopsies of inter-critical gout suggest ongoing NLRP3 inflammasome activity between gout attacks. @RheumNow #ACR22 Abstr#1808 https://t.co/OnJOpkRqH9 https://t.co/TGd6pn8Lne

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Nair et al. HLA-B*5801 allele in African American gout patients. Present in 8%. Higher than expected, ?need for screening pre-allopurinol? @RheumNow #ACR22 Abstr#1793 https://t.co/KrsjQ836BY https://t.co/bmPyqQi7OF

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Hayashi et al. No effect of colchicine prophylaxis (vs NSAID or vs no prophylaxis) on MACE in re-analysis of CARES trial. @RheumNow #ACR22 Abstr#1809 https://t.co/I6evAl4BLd https://t.co/n70FvYah1p

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Gurwith et al ABP-671 a URAT1 inhibitor effectively lowers serum urate @RheumNow #ACR22 Abstr#1822 https://t.co/hXAQoVHrLH https://t.co/saVqu4kbnr

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Lin et al. Genetic risk (HR 2.3 women, 2.63 men) and lifestyle (HR 5.7 for women, 3.7 for men) both individual contributors and synergistic (HR 9.1 women, 8.7 men) in gout development in both men and women. Modifiable! @RheumNow #ACR22 Abstr#1633 https://t.co/51KPgfXn1w https://t.co/gOU7DfOKvt

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Helget et al. Subanalysis of STOP Gout. Allopurinol and febuxostat equal efficacy in CKD 3. More AKI with allopurinol 8.3% vs 2.4%. @RheumNow #ACR22 Abstr#1829 https://t.co/Z4JqYp4mTT https://t.co/xd8VGJVkNo

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Khanna et al Transdermal NaHCO₃ in gout flare. N=98. Response rate D7 95% vs 79% (p=0.01). Lower rescue med, 6% vs 20%. @RheumNow #ACR22 Abstr#1787 https://t.co/DWtlvjzBHw https://t.co/DOk993gCwz

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Ho et al. Consistent colchicine use assoc reduction in MACE in patients with gout and pre-existing CVD. @RheumNow #ACR22 Abstr#1815 https://t.co/tXwa2FrSrp https://t.co/8TKl4z7iaH

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Flood @FloodRachael et al. ULT reduces non-episodic foot pain in hyperuricaemic patients who fail to meet gout classification criteria. Predicted by double counter or tophus on US. @RheumNow #ACR22 Abstr#1828 https://t.co/iOy0Vo5HVO https://t.co/vF98DFB7hJ

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
McCormick et al Fruit juice and other sugar-sweetened drinks increase gout flare in dose-dependent manner @RheumNow #ACR22 Abstr#1805 https://t.co/aGg5i5XyTK https://t.co/x8ChwASM6P

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Johnson et al. VA matched cohort study. 560,000 gout patients, 5.4 million controls. Gout asoc with increased CV risk of 68% HF hospitalization, 25% HF-related death, 22% MACE. Poor SU control assoc CVD events. @RheumNow #ACR22 Abstr#1580 https://t.co/CBSMFRpg82 https://t.co/6IS3Cozjzs

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Richard Conway @RichardPAConway( View Tweet )
Nov 14, 2022
Black et al. Treat to target in gout. Monthly rheumatologist review and urate titration vs 6-monthly. 89% vs 40% at target ≤0.30mmol/L (<5mg/dl). SU decrease 38% vs 18%. US features also improved. @RheumNow #ACR22 Abstr#1579 https://t.co/TvxWAtl83y

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Richard Conway @RichardPAConway( View Tweet )

Nov 14, 2022
Data like this make us think even in the setting of a controlled clinical trial in #gout, non-white patients much less likely to achieve target serum urate! Black pts 70% less likely to reach target compared to whites! #ACR22 @RheumNow abst#1583 https://t.co/dYet7pk2l5
Bella Mehta @bella_mehta( View Tweet )
Nov 13, 2022
Protective effect of #allopurinol in gout Dose dependent reduction in risk of acute coronary syndrome in incident #Gout #ACR22 @RheumNow abst#1582 https://t.co/PrEtRwvLvm
Bella Mehta @bella_mehta( View Tweet )
Nov 13, 2022
Fukui et al. Association different alcoholic drinks and urate in Japan. Patients always ask about this. We should drink more sake it seems! @RheumNow #ACR22 Abstr#1206 https://t.co/En5pSMUNp7 https://t.co/c67r9fsHJT

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Richard Conway @RichardPAConway( View Tweet )
Nov 13, 2022
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ACR 2022 - Day 1 Report

Jack Cush, MD
Nov 13, 2022

The masses have returned to ACR22, a live, face-to-face, and virtual, meeting that began Saturday in Philadelphia. There were hassles and glitches, yet the education and sessions were as you’d expect with many good presentations worth recapping.

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ACR Best Abstracts - Day 1

Jack Cush, MD
Nov 12, 2022

The RheumNow faculty reporters have been scouring the meeting and online presentations to find the best abstracts from ACR22. Here are some of their choice abstracts reported today on day 1 of ACR 2022 (#ACRbest).



 

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Adding MTX to Pegloticase for 52 wks in gout ◦ Improved response rate by 30% ◦ Reduced discontinuation rate by 40% ◦ Greater resolution of tophi by 20% ◦ Similar safety profile in MTX vs non-MTX groups Botson J, MIRROR RCT https://t.co/ifXLdvOv0K #ACR22 #ACRBest @RheumNow https://t.co/le9ggUa2Xk

Links:

Dr. Antoni Chan @synovialjoints( View Tweet )
Nov 12, 2022
This work can lay foundation to so much more! #ArtificialIntelligence and #naturallanguageprocessing on Facebook private #gout groups - Mental health mentioned in 4% of all posts/comments - primary care asso with “trust” and urgent care with “fear” @RheumNow #ACR22 abst#0201 https://t.co/fSuOeNGWvg
Bella Mehta @bella_mehta( View Tweet )
Nov 12, 2022
Botson et al. 52 week results MIRROR trial. MTX added to pegloticase. 71% vs 39% SU <6mg/dl. Infusion reaction 13% vs 32% if ab+ 0% vs 30% ab- @RheumNow #ACR22 Abstr#0001 #ACRbest https://t.co/1c3Va9NxNX https://t.co/dPGDyWue4G

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Richard Conway @RichardPAConway( View Tweet )
Nov 12, 2022
Black study subjects remain underrepresented in rheumatology clinical trials except for gout. Abs 0089 Continued under-reporting of race and ethnicity in PsA trials. Abs 0090 We can do better #rheumtwitter #ACR22 @RheumNow https://t.co/lzFXxFxgNs and https://t.co/K9dYaaXCg8 https://t.co/VqQe1OCsKg

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Dr. Rachel Tate @uptoTate( View Tweet )
Nov 12, 2022

Recent Blogs

From the Archives: Rheumatology Dead Word Cemetery

Jack Cush, MD
Oct 31, 2022
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I recently heard of a secondary school assignment wherein students were challenged to “bury” a word that was no longer useful or appropriate. Their exercise has now evolved into an unofficial RheumNow task force to retire diagnostic terms that have grown into misuse in rheumatology and medicine. How did we decide which words should perish? And by what criteria? Who has the final say? Read Post

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