Speaker: Date: Topic
Fadi Badlissi, MD
Feb. 20, 2013
Gout, Outpatient and Inpatient Conundrum: Do We Complicate Matters More Than We Need To?
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Take-Away Points of the Lecture
1. Always combine the initiation of uric acid lowering agents with preventive Rx such as NSAIDs or colchicine.
2. Target uric acid < 6 mg/dl.
3. No need to reduce a stable dose of allopurinol for renal insufficiency as long as it is tolerated.
Articles Cited in the Presentation
1. Khanna D et al: 2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res 2012 Oct;64(10):1431-1446.
2. Khanna D et al: 2012 American College of Rheumatology guidelines for management of gout. Part 2: Therapy and anti-inflammatory prophylaxis of acute gouty arthritis. Arthritis Care Res 2012 Oct;64(10):1447-1461.
3. Jordan KM et al: British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford) 2007 Aug;46(8):1372-1374.
4. Zhang W et al: EULAR evidence based recommendations for gout. Part 1: Diagnosis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006 Oct; 65(10):1301-1311.
5. Zhang W et al: EULAR evidence based recommendations for gout. Part II: Management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis 2006 Oct;65(10):1312-1324.
6. Choi HK et al: Pathogenesis of gout. Ann Intern Med 2005 Oct.4;143(7):499-516.
7. Kramer HM & Curhan G: The association between gout and nephrolithiasis: the National Health and Nutrition Examination Survey III, 1988-1994. Am J Kidney Dis 2002 Jul;40(1):37-42. SEE PDF ATTACHED AT END OF ARTICLE.
8. Arromdee E et al: Epidemiology of gout: is the incidence rising? J Rheumatol 2002 Nov;29(11):2403-2406
9. Lawrence RC et al: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis Rheum 2008 Jan;58(1):26-35.
10. Terkeltaub RA et al: High versus low dosing of oral colchicine for early acute gout flare: Twenty-four-hour outcome of the first multicenter, randomized, double-blind, placebo-controlled, parallel-group, dose-comparison colchicine study. Arthritis Rheum 2010 Apr;62(4):1060-1068.
11. Sundy JS et al: Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials. JAMA 2011 Aug 17;306(7):711-720
.12. Becker MA et al: Long-term safety of pegloticase in chronic gout refractory to conventional treatment. Ann Rheum Dis 2012 Nov 10 [Epub ahead of print].