Gout

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Best Rheumatologists (7.19.2024)

Jack Cush, MD

This week on the RheumNow Podcast, Dr. Jack Cush reviews the news and journal reports of interesting, including irAE, pollution and Psoriasis, microwave therapy, scleroderma without scleroderma that only the best rheumatologists could discern.

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Febuxostat is assoc w/ a reduced risk of kidney events and slower decline in eGFR. Metanalysis of 16 RCTs, shows febuxostat w/a reduced risk of kidney events (RR=0.56) & slower decline in eGFR; & reduced urine albumin to creatinine ratio https://t.co/GQ8UopbA88 https://t.co/WQskc1yZ02

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Dr. John Cush @RheumNow( View Tweet )
Medscape review of new Gout research from EULAR 2024 - Phase 3 trial program for SEL-212 - Safety of SEL-212 - New Selective URAT1 Inhibitors - ruzinurad & AR882 https://t.co/szVRO2sqpu https://t.co/B9LcdpeCGd

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Dr. John Cush @RheumNow( View Tweet )
Sobi has submitted a biologics license application to FDA for SEL-212 (pegadricase a uricase enzyme that breaks down uric acid) based on DISSOLVE I & II RCTs. SEL-212 was given FDA FDA’s Fast Track designation in March 2024 https://t.co/TPcUnCJOxT https://t.co/X1DrFDJZeK

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Dr. John Cush @RheumNow( View Tweet )
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Pollution and Autoimmunity (7.12.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal articles from the past week on RheumNow.com.

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POS0277: proof of concept: Prophlx with canakinumab x 1 dose rather than steroids/colch/NSAIDS when starting pegloticase with MTX in pts with active, refractory gout: 11 pts: #gout flares 0 (compared 54% in MIRROR-C), infusion rxn 0, no safety signal @rheumnow https://t.co/4qFnQTOuq0

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TheDaoIndex @KDAO2011( View Tweet )
Great 1st #EULAR2024 scientific session: “Asymptomatic” Hyperuricemia — innocent bystander vs. menacing foe. Data re: effects on joints, kidneys, & heart have not supported clear clinical consequences w/ exception of kidney crystal deposition. TIGER Study results eagerly awaited. https://t.co/IPQU3Ww0NA

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Tuhina Neogi, MD, PhD @Tuhina_Neogi( View Tweet )
Flavinoids (herbs, cherries, berries) have clinical efficacy in #Gout. Review of the mechanisms of flavonoids in gout includes: - Cox-2 inhibition - Lowers xanthine oxidase activity (mediated thru inflammasome, NOD/TLR4, NFKB, OAT1 & OAT3 transporters https://t.co/UC55GGZBCJ https://t.co/L6nE3BMIj1

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Dr. John Cush @RheumNow( View Tweet )
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Is Cannabis Safe? (6.7.2024)

Jack Cush, MD

Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!

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Role of Diet in Gout Risk Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout. https://t.co/cqP7G4KeWi https://t.co/zxiOeACb5u

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Dr. John Cush @RheumNow( View Tweet )
Canadian study of 44,438 older adults (age 76) w/ gout found only 52% reached serum uric acid (SUA) target w/in 12-mos, improving from 45% (2010) to 61% (2019). ULT adherence was 55%, also improved annually. Only 3.5% Rx by Rheumatologist! https://t.co/vAc8myxiRm https://t.co/gcMz379iPH

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Dr. John Cush @RheumNow( View Tweet )
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Role of Diet in Gout Risk

Jack Cush, MD

Diet has long been influential in gout care and risks. A large cohort study has shown that plant-based diets may reduce the risk of developing gout.

This prospective study assessed the risk of developing incident gout based on consumption of healthy and unhealthy plant-based diets.

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Colchicine prophylaxis w/ allopurinol (“start-low go-slow” 100mg escalation strategy), is best used in pts w/ gout flare in month prior to allopurinol. Longer prophylaxis may be required w/ ongoing flares in 1st 6mos of allopurinol if T2T not achieved https://t.co/yupiq26BJA https://t.co/KDF394SC30

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Dr. John Cush @RheumNow( View Tweet )
Save the date! We are covering #EULAR24! We'll be sharing recaps, videos, and more. https://t.co/NMWtHB94Pi https://t.co/ok43pnagFg

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Dr. John Cush @RheumNow( View Tweet )
Metformin Lowers Gout Risk in Pre-Diabetes A large, propensity score-matched cohort study shows that metformin use in patients with pre-diabetes significantly lowers the risk of future gout. https://t.co/IQ1Z7rhhp1 https://t.co/vYKBKsWh0y

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Dr. John Cush @RheumNow( View Tweet )
metformin

Metformin Lowers Gout Risk in Pre-Diabetes

Jack Cush, MD

A large, propensity score-matched cohort study shows that metformin use in patients with pre-diabetes significantly lowers the risk of future gout. 

Metformin is widely used for diabetes and pre-diabetes. Importantly, its use has been linked with a

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Do you have a rheumatology question or case for Dr. Cush? Record it here and we may feature it on an upcoming podcast. Tell us your name and where you practice rheumatology. https://t.co/qvVEUoNYi5 https://t.co/duw6jg5xpp

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Dr. John Cush @RheumNow( View Tweet )
Save the date! We’ll be covering #EULAR24! https://t.co/HGjP2SFyOp
Dr. John Cush @RheumNow( View Tweet )
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"Don't You Know Who I am?" (5.17.2024)

Jack Cush, MD

Dr. Jack Cush reviews the news and journal reports from the past 2 weeks. This week's question: can we prevent gout, ILD or psoriasis?

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Single center EHR study of 5 064 pts w/ pre-diabetes compared those starting metformin (1154) vs 13 877 non-users w/ ~4 yrs F/U. Incidence of future gout was lower w/ metformin use (7.1 vs 9.5/1000PYs; HR 0.68); with no change in SUA or CRP https://t.co/CXdcEdWXhW https://t.co/j0ktehf9Sm

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Dr. John Cush @RheumNow( View Tweet )
MGH study compared 1148 acute CPPD vs 3730 controls (mean 73 yrs) found 2 fold more fractures (mostly wrist); 11.7 vs 5.5/1000 PYs (HR 1.8) in pseudogout pts (also had more steroids & OP) https://t.co/HhCV6fYubF https://t.co/3bcbvSzzPo

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Dr. John Cush @RheumNow( View Tweet )
RISE study of 700 Pegloticase users (14 mos F/U) found 18% on immunosuppressive (MTX, MMF, LEF), these had signif less PEG D/C (HR 0.52-0.69). Immunosuppressives not assoc w/ more lab abnormalities https://t.co/4ytot7HOMh https://t.co/0wrjvnZur3

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Dr. John Cush @RheumNow( View Tweet )
Is Colchicine Rx a problem? Retrospective study of UK Clinical Practice registry, 13945 gout initiated allopurinol with colchicine (64yrs; 78% male). 26% on 1+ meds interacting w/ colchicine. Diarrhea & MI more freq w/ comorbidities & more severe CKD https://t.co/ZkhpzaTjjI https://t.co/e3BO813b30

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Dr. John Cush @RheumNow( View Tweet )
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Rheum Chapter Notes (4.26.2024)

Jack Cush, MD

Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.

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SGLT2 Inhibitors Lowers Gout Risks in Type 2 Diabetes A population-based cohort has demonstrated tha SGLT2i use in gout patients is superior to sulfonylurea therapy in lowering the risk of incident gout and recurrent flares among patients withT2D. https://t.co/QZ7bt39zEW https://t.co/Wlo9SF0hPF

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Dr. John Cush @RheumNow( View Tweet )

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