An international panel of rheumatologists issues new recommendations for the diagnosis and management of gout -- hoping to improve often uneven and suboptimal patient care that exists despite numerous care guidelines and new therapies.
A small exploratory study suggests that intensively lowering urate levels in tophaceous gout improves structural damage seen on radiography, particularly bone erosion.
The interleukin-1 inhibitor dampened the bouts of pain by more than 70% for gout patients as they begin urate-lowering treatment in the international PRESURGE-2 trial.
They may be supported by guidelines and commonly used in practice, but joint injections with glucocorticoids for acute gout are not backed by any randomized controlled clinical trials, according to a new Cochrane report. However, the report backs away from saying they should not be used.
The RADAI joint index designed for rheumatoid arthritis patients provides equally powerful information about disease status in osteoarthritis and psoriatic arthritis, according to a new comparative study. As a guide to severity, it is much quicker than waiting for lab results to come in.
Despite hopes that rilonacept might provide a better alternative to NSAIDs or colchicines for gout pain, it does not provide significant relief either on its own or as an add-on therapy to indomethacin.
Does this evidence from recent research overturn some generally accepted principles about gout, rheumatoid arthritis, reactive arthritis, and osteoarthritis? Most of these studies were undertaken in order to test ideas that were described as common wisdom in rheumatology.
Dual-energy CT scans of ligaments and bones in patients with tophaceous gout showed patterns of monosodium urate crystal deposition suggestive of a role for biomechanical strain. The Achilles tendon was the most commonly involved site.
Used for gout for centuries, colchicine is known to be peculiarly toxic at high doses. A new understanding of its potential for poisoning, deliberate or otherwise, merits attention to its often-underestimated risks.
Among the revelations about gout treatment at this year’s meeting: Confusion among physicians about the definition of “control,” misunderstandings among gout patients about their own disease, and new drug options.