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EHR study of UK Clinical Practice Research Datalink studied 318 hospitalized gout pts showing there is a 30d increased risk of VTE after gout flare aIRR 2.31 (1.39-3.82), that disappeared 31-90d after.
Tigulixostat is a non-purine xanthine oxidase inhibitor studied in 143 gout pts vs PBO with goal of SUA < 5. TIG was effective at 50mg (47%), 100 mg (45% ), 200 mg (62%) vs PBO 2.6% at week 12; w/ more gout flares in PBO Rx pts (13% vs 9%)

Half the Experts are Wrong (2.17.2023)

Feb 17, 2023

Dr. Jack Cush reviews the news and tries to stump the expert panel this week on the podcast.

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Retrospective study of 64 gout pts having orthopedic surgery - perioperative flares more likely with Incr SUA, DM, tophi and diuretics. In 12 mos following surgery, recurrent gout more if ^SUA (45% vs 11%) & those w/ topic ((RR = 4.8; P = 0.029)
New Guideline: Vaccinations OK With Few Tweaks for Rheum Patients Nearly all available vaccines can be given to people with rheumatologic diseases, according to a new, detailed guideline from the ACR.
Feb 3rd, today is #NationalWomenPhysiciansDay. The date honors Dr. Elizabeth Blackwell, 1st woman to receive an MD United States (1849). RheumNow will devote the whole month of April 2023 to our Campaign on Women in Rheumatology - stay tuned!
Rheumatic Disease - IBD Overlap Nearly one in 10 patients with IBD also have rheumatologic disorders, meaning that specialists have to talk to each other to develop a treatment plan that works for both conditions, a researcher suggested.

Coffee with milk may have an anti-inflammatory effect

Jan 30, 2023

Can something as simple as a cup of coffee with milk have an anti-inflammatory effect in humans? Apparently so, according to a new study from the University of Copenhagen. A combination of proteins and antioxidants doubles the anti-inflammatory properties.

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Have a Rheumatology question or case for Jack Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology.
Burden of BMI on Costs of Musculoskeletal Diseases A cross-sectional global study shows a substantial impact of obesity and BMI on the health and economic impact of patients with musculoskeletal (MSK) disorders.

Burden of BMI on Costs of Musculoskeletal Diseases

Jan 23, 2023

A cross-sectional global study shows a substantial impact of obesity and BMI on the health and economic impact of patients with musculoskeletal (MSK) disorders.

In this cross-sectional study of 192 countries and territories, 7.3 million years lived with disability and $180.7 billion

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PsA Til Death Do Us Part (1.20.2023)

Jan 20, 2023

Dr. Jack Cush reviews the highlights from the past week on

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Elevated Uric Acid Is Associated With New‐Onset Atrial Fibrillation

Jan 16, 2023

A Longitudinal Swedish study has shown that elevated serum uric acid (SUA) levels has cardiovascular implications and may predict the development of atrial fibrillation (AFib). 

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AR882, selective uric acid transporter 1 (URAT1) inhibitor in development, completed a phase 2, 140 pt 12-week PBO controlled trial, where 75 mg/d lowered SUA by 59% (8.6 to 3.5 ) & 42% (8.6 to 5.0 ) in 50 mg dose group - all better than PBO
UK Database 1,955 breakthrough COVID-19 infxs in 54,576 #gout pts compared to 52,468 w/o gout saw more in gout (adj HR 1.24), also w/ more #COVID hospitalizations (adj HR 1.30) & death (1.36), more so in women. Same for unvaccinated
The Daily Mail in the UK features a long review of Hx of #Gout (Disease of Kings) & being on the rise in the UK - features a video interview with Professor Philip Conahan (one of our speakers at RheumNow Live 2023!)

Lubricin as a Treatment Target in Gout?

Jan 04, 2023

Many Americans think of gout as a disease from a bygone era, akin to rickets or scurvy. The condition commonly afflicted the rich and royal, including American historical figures such as Benjamin Franklin and Thomas Jefferson.

Gout is indeed one of the earliest known diseases, first

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Best of 2022: Allopurinol Safety in CKD Patients

Dec 30, 2022

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.

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Cool NEJM Case of Spinal Gout in 82-yr-old woman with 3-wk hx of severe LBP, rigors, anorexia, incomplete urination. Hx of PsA, CKD, CHF treated w/ Humira, HCQ, diuretics. Imaging tophi in spine, responded to steroids and allopurinol.
Study of 1141 consecutive gouty pts finds 10 (0.9%) with "Shrinking Toes" in those w/ tophaceous gout (usually MTP1,2) - toe shortening mainly due to lytic bone collapse during articular tophus dissolution (esp in severe gout w/ severe erosions)
Allopurinol Use Does Not Increase Mortality in Gout w/ Chronic Kidney Disease A trial has shown that allopurinol use dose escalation and achieving target uric acid levels, was not associated w/ increased mortality in patients with gout and concurrent CKD. https…
Hyperuricemia as a biomarker of severe #PsA? Study of 242 PsA pts 30% had hyperuricemia &amp; 6% had gout. Hyperuricemia was significantly associated with age, comorbidity, perph polyarthritis, Jt destruction, less response to treatment.
Practical Guidance for the Clinical Rheumatologist in Unplanned Pregnancies Women of reproductive age comprise an overwhelming majority of patients with rheumatic and musculoskeletal disease.
National cohort of 20–39-yr old men - among ~1.3 million, 18,473 Dx w/ gout (incidence 3.36/1,000 PY). Developing metabolic syndr doubled #gout risk (aHR 2.31); MetS at all visits had 4x risk (aHR 3.82) & MetS recovery reduced gout risk by 59%
Retrospective study of US National Inpatient Sample data 2015-2019 looked at 60,360 gout admissions, roughly 1/4 had Arrhythmias (mostly older pts; AFib (88%), atr flutter (6.2%), VTach (3.2%). Gout-arrhythmia pts had more deaths (adj OR 2.06)