Gout
Remains under-treated
Higher success when pharmacists and RNs manage ULT
Abs 2220, 1247, 1272
Roundup – Cush, Kavanaugh #ACR18 @RheumNow— D White (@WIRheum) October 24, 2018
What’s in a name. Gout by any other name may be better treated. All hail Urate Crystal Arthritis#ACR18@RheumNow Abstract268 pic.twitter.com/iGEENPJM85
— William Shergy (@WilliamShergy) October 21, 2018
Abstract 2220: gout flares and allopurinol use population study. Unfortunately, gout is *vastly* undertreated. Similar abstracts 1247, 1272 show that pharmacist driven gout care can work well #ACR18 pic.twitter.com/09A85ehnf1
— Dr. Paul Sufka (@psufka) October 24, 2018
#ACR18 poster 1265:
Gout management in primary care can be improved with a thoughtful structured approach. Quantity and quality of ULT improves; proportion failing to meet SUA target fell from 64% to 39%. Exemplary approach to gout care. @RheumNow pic.twitter.com/GeE5RRU0Pr— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 22, 2018
Dr. Cush
ABSTRACT: 2220
Gout, Flares and Allopurinol Use: A Population Based Study. —Australian study, large number of under treated with rate lowering therapy. Also, see abstracts: 1247, 1272. #ACR18 @Rheumnowhttps://t.co/BJKqxFtuvG— Suleman Bhana, MD (@DrBhana) October 24, 2018
#ACR18 poster 2220
Great population-based #gout data from South Australia. Prevalence 6.5%. 1/4 report at least 2 flares/yr but only 1/2 of these are current allopurinol users. Flares associated with reduced HRQoL.
Work remains to be done to reduce gout burden. @RheumNow pic.twitter.com/HfVi0jyGqT— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 23, 2018
#ACR18 poster 2229
More great #gout data from NZ. Only a small proportion undergoing dose escalation of allopurinol don’t reach target. Contribution of adherence vs genes (vs other) in this group still unclear.
THM is that most get to target if you push dose up. @RheumNow pic.twitter.com/9ocXUWQFui— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 23, 2018
We are still doing a poor job in managing hyperuricemia and gout. #ACR18 @RheumNow Abstract2237 pic.twitter.com/uFnk6gQR8X
— William Shergy (@WilliamShergy) October 23, 2018
Filming now: our gout panel with these terrific people. We'll post it up tonight on https://t.co/X7Lh9aCbYf. #gout #ACR18 pic.twitter.com/45xhhGs31t
— Dr. John Cush (@RheumNow) October 23, 2018
prevalence of gout in the hip may be underestimated, as shown in abstract #2240 by use of ultrasound @RheumNow #ACR18
— Cassandra Calabrese (@CCalabreseDO) October 23, 2018
Abst L01 Risk of CV events in gout pts on XOI higher in pts with preexisting CVD: 16 events w/prior CV (23.2%), vs 6 w/no prior CV events (3.2%). Out of 22 CV events, higher incidence w/FBX (20.9%)vs ALLO (6.1%),p<0.001. Colchicine use comparable in all
#acr18 @rheumnow— Olga Petryna (@DrPetryna) October 23, 2018
abstract #2221 provides insight into early onset gout – often severe clinical course, and may be associated with serum urate-associated SNP ABCG2 141k @RheumNow #ACR18
— Cassandra Calabrese (@CCalabreseDO) October 23, 2018
Do you maintain or discontinue allopurinol during a gout attack?@RheumNow #ACR18
— Cassandra Calabrese (@CCalabreseDO) October 23, 2018
In mice with induced #gout, oral administration of #cherryjuice concentrate reduced #NFkappaB activity compared to control. #cherryjuiceingout #ACR18 @RheumNow
— Nicole Bitencourt (@NicoleBitencou5) October 22, 2018
chronic refractory gout patients receiving pegloticase – reduced renal function does not compromise resolution of tophi with pegloticase, if sUA reduction is sustained abstract #1282 @RheumNow @HealioRheum #ACR18
— Cassandra Calabrese (@CCalabreseDO) October 22, 2018
#ACR18 #870 Dr Khanna: US population survey of self-reported #gout.
Prev gout 3.1%. Mean 6.5 flares per yr, but only 2 flares reported to doctor.
ULT not predictive of flare prevalence.Is burden of gout higher than we thought?
Good qualitative study needed next. @RheumNow
— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018
What is your max dose of Allopurinol for chronic gout?
— Dr. John Cush (@RheumNow) October 23, 2018
In mice with induced #gout, oral administration of #cherryjuice concentrate reduced #NFkappaB activity compared to control. #cherryjuiceingout #ACR18 @RheumNow
— Nicole Bitencourt (@NicoleBitencou5) October 22, 2018
#ACR18 poster 1298.
Fascinating study by Jas Singh suggesting an association between #gout and incident Parkinson’s disease. If a true association (most potential confounders included but not alcohol or meds), then interesting to speculate on mechanism. @RheumNow pic.twitter.com/1ZL0Sm74U1— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 22, 2018
#ACR18 @RheumNow gouty panniculitis (abs TMP3) treated with pegloticase. pic.twitter.com/QTdSsUCcQy
— Ian N Bruce (@Lupusdoc) October 22, 2018
Gout in solid organ transplant recipients – Cyclosporine is not the only culprit drug, other transplant regimens also to blame! abstract #1289 #CleClinicRheum @RheumNow
— Cassandra Calabrese (@CCalabreseDO) October 22, 2018
#ACR #874 Hyon Choi.
Data from >44k men in health prof study: 80% of population attributable risk of incident gout accounted for by 5 modifiable risk factors (weight, diet, alcohol, diuretics, vit C). Overweight biggest contributor.#SocialDeterminants #SDOH @RheumNow pic.twitter.com/Q2cH5zCGz9
— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018
#ACR18 #872 Dr Fu.
12,234 gout patients in robust Israeli cohort. Cumulative exposure to SUA >6mg/dL associated with CKD, but not CVD. Most interestingly, association between SUA and overall mortality was U-shaped.@RheumNow pic.twitter.com/V5dfRA6vaP
— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018
#ACR #871 Dr Major. Data on 16,760 Americans (general pop) show genetic factors have >10x impact on the variance in serum uric acid compared with dietary factors.
Doesn’t mean we should ignore diet (eg may still trigger flares) but perhaps we can obsess less. @RheumNow pic.twitter.com/9uiUhRDcCW— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018
#ACR18 #870 Dr Khanna: US population survey of self-reported #gout.
Prev gout 3.1%. Mean 6.5 flares per yr, but only 2 flares reported to doctor.
ULT not predictive of flare prevalence.Is burden of gout higher than we thought?
Good qualitative study needed next. @RheumNow
— ǝlʇʇıɥʍ ɯɐs (@samwhittle) October 21, 2018
Failure to adequately treat gout could be deadly. #ACR18 @RheumNow Abstract 869 pic.twitter.com/HtcpH2RlAt
— William Shergy (@WilliamShergy) October 21, 2018
What’s in a name. Gout by any other name may be better treated. All hail Urate Crystal Arthritis#ACR18@RheumNow Abstract268 pic.twitter.com/iGEENPJM85
— William Shergy (@WilliamShergy) October 21, 2018