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Highlights from ACR's 2020 Gout Guidelines

In this week's news roundup, we highlight two studies that examine risks associated with biologics used to treat rheumatic disease. We also highlight the 2020 treatment guidelines for gout issued this week by the American College of Rheumatology. In today's video, we feature an interview with John D. Fitzgerald, M.D., Ph.D., chief of rheumatology at Ronald Reagan UCLA Medical Center in Santa Monica. Dr. Fitzgerald served as the corresponding author of the guidelines.

The American College of Rheumatology has updated its treatment guidelines for gout. The guideline includes 42 treatment recommendations, of which 16 are  now strongly recommended. They address standard treat-to-target urate lowering therapy, the use of allopurinol and more. In this slideshow, we highlight the 16 strongest recommendations. 

The rate of serious infections in people with gout, especially sepsis and pneumonia, is increasing, and certain patient characteristics and external factors are associated with both higher healthcare use and in-hospital mortality in these patients, according to one of the first U.S. studies to describe the epidemiology of hospitalized serious infections in gout.

Colchicine for gout

Colchicine, a first-line treatment option for acute gout, is associated with an increased risk of adverse events, such as diarrhea and other gastrointestinal symptoms, but not serious adverse events, finds a newly published systematic review and meta-analysis.

gout treatment gout drugs

A new study published in the February 5 issue of Annals of the Rheumatic Diseases finds that allopurinol and febuxostat are associated with about the same risk of hypersensitivity reactions, as compared to gout patients treated with colchicine. The risk is even higher for women and diabetes patients, the authors wrote.

The suggestion that DECT scans might add to our diagnostic ability to detect cardiac disease may be imprudent because we have tests at our disposal and have little need to increase diagnostic costs. Good clinical judgement, paying attention to traditional risk factors and to red flags, will increase the number of asymptomatic cardiac patients we choose to study with conventional methods.

Gout Attacks Intensify with Heart Failure

ACR Annual Meeting:  Gout patients who are admitted to the hospital with worsening heart failure, go on to have gout attacks during hospitalization leading to longer hospital stays, researchers reported November 10 at the annual meeting of the American College of Rheumatology in Atlanta.

Gout, a common comorbidity in renal transplant patients.

In a study presented at the Clinical Congress of Rheumatology West held in San Diego last month, researchers led by Brian LaMoreaux, M.D.,  report that gout was found to be a “a common comorbidity in renal transplant patients.”

In this week's rheumatology news roundup, we feature a Q&A with Dr. Aryeh M. Abeles who talks with Rheumatology Network about his concerns with the black box warning label for the gout treatment febuxostat. We also include a story on addressing prescription abdandonment in rheumatoloyg. These and other stories in today's news roundup.

Black Box Blues for Gout Treatment Febuxostat

Aryeh M. Abeles, M.D., talks with Rheumatology Network about the FDA's black box label for febuxostat, a gout treatment which, according to the results of one clinical trial, was shown to be associated with an increased risk of mortality. In this Q&A, Dr. Abeles, says the decision was based on flawed data.