Thursday, 6 October 2016

First Treat-to-Target recommendations for gout

First Treat-to-Target recommendations for gout The first treat-to-target recommendations for gout based on the available scientific evidence have been published online September 22, 2016 in the Annals of the Rheumatic Diseases. The main treatment goal is to reduce levels of serum uric acid to a target of lower than 6 mg/dL and to maintain that level. While the target serum uric acid level in patients with severe gout, such as tophi or frequent attacks should be below 5 mg/dL. Decrease in pain, presence/absence of attacks and the amount/reduction/absence of tophi are other three treatment targets. The recommended outcome measures have been grouped into three: • Clinical: Pain, number of joints involved, number of attacks/year • Lab: Serum uric acid, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum creatinine • Patient-reported outcomes: Quality of life, short form 36, work status, productivity, work days off and absenteeism. The Expert Group recommends prompt treatment of acute attacks with appropriate anti-inflammatory drugs taking into consideration the presence of comorbidities. Educating patients about the disease, lifestyle changes and the need to adhere to treatment even in absence of acute flare-up of disease to reduce risk of hypertension, heart disease, and kidney disease is also highlighted in these guidelines. These recommendations were developed by an international Expert Group that included 11 rheumatologists, one cardiologist, one nephrologist, one general practitioner and one patient with gout.

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