ACR Convergence 2020—In May 2020, the ACR published its updated guideline for the management of gout.1 It followed on the heels of a 2017 gout guideline published by the American College of Physicians.2 Although the guidelines provide similar recommendations on the treatment of acute gout, they differ importantly in the use of uric acid-lowering therapy…
Rheumatologists who are outstanding clinicians and provide consistent, exceptional care to patients are in the spotlight in our Lessons from a Master Clinician series. Here, we present insights from a clinician who has achieved distinction in the field of rheumatology, serving as a role model for colleagues and trainees. Alan Baer, MD, is currently a…
Acute gout can be very painful, causing patients to seek treatment in the emergency department. A retrospective study of pain interventions for gout in Rhode Island found that nearly 30% of patients received prescriptions for opioid medications over 30 months. Of these prescriptions, over 80% were for patients who had never been exposed to opioids…
The umbrella term crystalline disease covers arthritic conditions caused by deposition of crystals and associated inflammatory response, including erythema, edema and intense pain. The two most common crystal-induced arthropathies are gout, an arthritis secondary to inflammation caused by the presence of monosodium urate (MSU) crystals formed through high levels of serum urate, and calcium pyrophosphate…
In May, the ACR released a new treatment guideline for the management of gout for simultaneous publication in Arthritis & Rheumatology and Arthritis Care & Research.1 Based on evidence from more than 130 published studies, the guideline makes a total of 42 recommendations—of which 16 are strong: It has 27 recommendations for urate-lowering therapy (ULT)…
Living like a king has its price. And while kings and queens are primarily something of yesteryear, the vast majority of those living in reasonably wealthy nations can now live like kings. Now, back to that price. Gout, once known as the disease of kings, has been around at least since the time of the…
Recent research assessed the risk of gout in patients with type 2 diabetes mellitus prescribed sodium-glucose cotransporter-2 (SGLT2) inhibitors compared with those prescribed a glucagon-like peptide-1 (GLP-1) agonist. The study found patients on the SGLT2 inhibitor had a lower rate of gout, suggesting SGLT2 inhibitors may actually reduce the risk of gout among this patient population…
Monosodium urate (MSU) crystal formation, deposition and gout flares frequently affect joints that have been damaged or are affected by osteoarthritis. These researchers examined the effects of human cartilage homogenates on MSU crystallization and MSU crystal-induced inflammation…
ATLANTA—The authors of the new draft ACR treatment guideline for the management of gout presented the draft guideline on Nov. 13 at the 2019 ACR/ARP Annual Meeting. Based on evidence from more than 130 published studies, there are 42 recommendations, of which 16 were strong, including 27 for urate-lowering therapy (ULT) management, 13 of which…
A recent study advances the understanding of factors associated with a target serum urate level of 6 mg/dL or less. Researchers found such factors as having a rheumatologist as the main provider of gout care contributed to achieving and maintaining this outcome. However, the presence of co-morbidities lowered a patient’s chances for achieving the target serum urate level, even with allopurinol use…