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Gout

Depression and RA Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week. https://t.co/nJZD4D2ByC https://t.co/ET3Xp9cK62
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Depression and RA (3.8.2024)

Dr. Jack Cush reviews the news, journal reports and regulatory approvals from the past week.

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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
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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. adults (53.2 million) had

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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
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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.



A matched case–control study examined the electronic health records from the UK Clinical Practice Research Datalink and compared gout (one to five) with controls

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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
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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
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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
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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
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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. https://t.co/F2eiWXOTkF https://t.co/YFftaITmnQ
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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)".





  1. Many #RA pts remain on Steroids despite b/tsDMARD use! Study 228 #RA pts

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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.



In JAMA, a retrospective review of 3613 gout patients with 3104 gout flares over 8.3 years showed an expected high rate of gout flares with higher baseline

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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
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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
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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
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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New Year's Resolutions (1.5.2024)

Dr. Jack Cush imparts his new New Year's Resolutions for 2024 and also reviews the news and journal reports from the past week on RheumNow.com.

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Do I have Arthritis? How I handle this frequent curbside consult question... https://t.co/uX6MUfy59w https://t.co/kYviOhcLQj
Dr. John Cush @RheumNow( View Tweet )