State of the Gout

The UnderManagement of Gout

Rheumatologists manage less than 3% of all gout patients in the United States (USA). In 2002, there…

The unclosing premature mortality gap in gout: a general population-based study

Objective Gout, the most common inflammatory arthritis, is associated with premature mortality. Whether this mortality gap has improved over time, as observed in rheumatoid arthritis (RA), is unknown. Methods Using an electronic medical record database representative of the UK general population, we…

The current state of affairs of Gout is dismal. Mortality numbers have not improved (numerically worsened, actually) in the last 16 years, in stark contrast to RA, which has been transformed by the biologics revolution and the Treat-to-Target strategy. Acute hospitalization rate for Gout soared while that of RA has steadily decreased over the years. What are we doing wrong?

Gout hospitalization exacerbated by failure to prescribe recommended urate-lowering treatment

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The results of a Swedish study presented today at the Annual European Congress of Rheumatology…

Gout (and its attendant morbidities) is what happens when doctors fail to treat serum uric acid level to target.

First treat-to-target gout trial supports allopurinol dose escalation

Gradually ramping up the dose of allopurinol to achieve target serum urate levels in gout patients who tolerate the drug is safe and effective, even in those with chronic kidney disease.

The Economic Value of Genetic Testing for Tolerance of Allopurinol in Gout

Gout affects around 0.08% of the population globally and is the most common cause of inflammatory arthritis in men1. Gout is associated with a considerable economic burden to healthcare systems; gout patients incur substantially greater direct healthcare costs compared to the healthy population2,3.…

The fear of potentially fatal reaction to Allopurinol, the most commonly prescribed urate lowering agent, is what is preventing the optimal treatment of Gout.

While the gene, HLA-B5801 is strongly associated with Allopurinol-induced SCAR (Severe Cutaneous Adverse Reaction), the numbers are small: by most epidemiological estimates, about 10% of Han Chinese carry the gene, but only 2% of carriers develop SCAR on Allopurinol.

Gout Treatments Effective If Patients Maintain Lifelong Adherence to Therapies

Although gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases long term, as shown by many studies. “Treatments are excellent, yet are dramatically under-utilized,” says Theodore Fields, MD, FACP, rheumatologist, Hospital for Special Surgery (H…

If I tell you that you have a medical condition that can potentially lead to disabling consequences and premature death, but which can be prevented by daily medication for life, would you take it?

It probably depends on whether you believe what I’m warning you about, and the assurance that the cure is not worse than the disease. This would then justify the inconvenience of daily lifelong medication. It’s much like buying life insurance: it is a long-term commitment.

Therefore, the key to successful Gout treatment is education.