gout Tag
![MedicalResearch.com Interview with: Jeffrey D. Kent, M.D., FACG, FACP Executive Vice President, Medical Affairs and Outcomes Research Horizon MedicalResearch.com: What is the background for this study? What is the marker for reduced immunogenicity with Pegloticase? Response: Pegloticase is a recombinant, pegylated uricase that is used for treatment of chronic gout in patients who fail oral urate lowering therapy (uncontrolled gout) and has a demonstrated impact on the serum uric acid (sUA) level. As with other biologics, in some people the body’s immune system develops anti-drug antibodies and reduces the effectiveness of the biologic therapy. Recent case series and open-label trials have suggested that using an immunomodulator with pegloticase has the potential to increase the durability of response so patients can receive a full course of therapy. Researchers in the RECIPE trial sought to examine whether the co-administration of disease-modifying antirheumatic drugs (DMARDs), specifically mycophenolate mofetil, may mitigate this loss of efficacy and increase in response rates for people living with uncontrolled gout MedicalResearch.com: Are symptoms of gout improved as well as reduced infusion reactions? Response Results from this trial indicated that short-term concomitant use of mycophenolate mofetil with pegloticase was generally well tolerated. It was also associated with a statistically significant and clinically meaningful impact on the proportion of patients achieving and maintaining an sUA ≤6 mg/dL at 24 weeks. No infusion reactions were reported in the pegloticase/mycophenolate mofetil arm (0 or 22 patients) compared to 30 percent (3 of 10) of patients reporting infusion reactions in the pegloticase/placebo arm. It’s been well established that in patients receiving pegloticase with persistent urate lowering, they experience relatively rapid resolution of tophi indicating significant reductions in their urate burden. MedicalResearch.com: What are the main findings? Response: This is the first randomized controlled trial evaluating pegloticase co-prescribed with an immunomodulator compared to pegloticase with placebo. Data showed that 86.4 percent of patients (19 of 22) receiving co-therapy of pegloticase with mycophenolate mofetil achieved an sUA ≤ 6 mg/dL through Month 3, the primary study endpoint, compared to 40.0 percent of patients (4 of 10) receiving pegloticase monotherapy. After Month 3, all patients received pegloticase only and at Month 6 a sustained response was shown in 68.2 percent (15 of 22) of patients who had received pegloticase with mycophenolate mofetil versus 30.0 percent (3 of 10) of patients who received pegloticase and placebo. This data adds to the growing body of evidence on the concomitant use of pegloticase with an immunomodulator to ultimately help more patients receive a full course of therapy and improve outcomes and may help shift the treatment paradigm in uncontrolled gout. MedicalResearch.com: What should readers take away from your report? Response: While rheumatologists are familiar with and may use DMARDs for other autoimmune conditions to minimize the development of anti-drug antibodies and increase response to therapies, data shows that the use of an immunomodulating therapy in patients with uncontrolled gout can improve response rates. MedicalResearch.com: What recommendations do you have for future research as a result of this work? Response: There is a consistent pattern demonstrating that the concomitant use of pegloticase and an immunomodulator can improve patient outcomes without introducing additional toxicities. As clinicians we understand the immense burden gout places on our patients. Future research should continue exploring options to maximize the benefit of effective treatments to improve patient outcomes. MedicalResearch.com: Is there anything else you would like to add? Response: Uncontrolled gout is a chronic, systemic inflammatory condition and we continue to see data linking it to many comorbid conditions. Horizon is evaluating the use of methotrexate to improve response rates for pegloticase. We are committed to exploring various immunotherapy co-treatment options to allow both patients and clinicians to address elevated sUA levels to minimize urate burden and avoid lasting damage to the body. RECIPE is an investigator-initiated trial led by Puja Khanna, M.D., M.P.H. and Kenneth Saag, M.D., M.Sc. Citation: Khanna P, Khanna D, Cutter G, Foster J, Melnick J, Jaafar S, Biggers S, Rahman A, Kuo H, Feese M, Saag K. Reducing Immunogenicity of Pegloticase (RECIPE) with Concomitant Use of Mycophenolate Mofetil in Patients with Refractory Gout—a Phase II Double Blind Randomized Controlled Trial [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 10). https://acrabstracts.org/abstract/reducing-immunogenicity-of-pegloticase-recipe-with-concomitant-use-of-mycophenolate-mofetil-in-patients-with-refractory-gout-a-phase-ii-double-blind-randomized-controlled-trial/. Accessed November 12, 2020. [subscribe] Last Modified: [last-modified] The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.](https://medicalresearch.com/wp-content/uploads/2020/11/Dr-Jeffrey-Kent.jpg)
12 Nov Use of Pegloticase- KRYSTEXXA® with an Immunomodulator Improves Outcomes in Refractory Gout
MedicalResearch.com Interview with: [caption id="attachment_55936" align="alignleft" width="150"] Dr. Kent[/caption]Jeffrey D. Kent, M.D., FACG, FACP
Executive Vice President, Medical Affairs and Outcomes Research
Horizon
MedicalResearch.com: What is the background for this study? What is the marker for reduced immunogenicity with Pegloticase?
Response: Pegloticase is a recombinant, pegylated uricase that is used for treatment of chronic gout in patients who fail oral urate lowering therapy (uncontrolled gout) and has a demonstrated impact on the serum uric acid (sUA) level. As with other biologics, in some people the body’s immune system develops anti-drug antibodies and reduces the effectiveness of the biologic therapy. Recent case series and open-label trials have suggested that using an immunomodulator with pegloticase has the potential to increase the durability of response so patients can receive a full course of therapy. Researchers in the RECIPE trial sought to examine whether the co-administration of disease-modifying antirheumatic drugs (DMARDs), specifically mycophenolate mofetil, may mitigate this loss of efficacy and increase in response rates for people living with uncontrolled gout
24 Jun Does Lowering Uric Acid with Allopurinol Slow Progression of Chronic Kidney Disease?
MedicalResearch.com Interview with: [caption id="attachment_50193" align="alignleft" width="84"] Dr. Badve[/caption]
Sunil Badve MBBS, MD, DNB, FRACP, PhD, FASN
Staff specialist nephrologist | St George Hospital
Conjoint Associate Professor | University of New South Wales
Senior Research Fellow, Acute Kidney Injury and Trials
The George Institute for Global Health
Australia
MedicalResearch.com: What is the background for this study?
Response: Elevated serum urate levels are associated with progression of chronic kidney disease (CKD). CKD patients often have elevated serum urate levels due to decreased excretion.
We conducted this placebo-controlled randomized trial to evaluate if urate-lowering treatment with allopurinol would attenuate decline in estimated glomerular filtration rate (eGFR) over 2 years in patients with CKD. We enrolled 369 CKD patients with high progression risk and no prior history of gout.
15 Jun Persistent Uric Acid Reduction with Pegloticase May Lead To Reduced Liver Fibrosis
MedicalResearch.com Interview with: [caption id="attachment_54552" align="alignleft" width="200"]
Dr. LaMoreaux[/caption]
Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics
MedicalResearch.com: What is the background for this study?
Response: Hyperuricemia is associated with non-alcoholic fatty liver disease (NAFLD) but the relationship to fibrosis remains uncertain. Moreover, it is not known whether lowering serum urate will affect the course of NAFLD.
15 Jun Trends in Immunomodulation Co-Therapy with Pegloticase for Uncontrolled Gout
MedicalResearch.com Interview with: [caption id="attachment_54552" align="alignleft" width="200"] Dr. LaMoreaux[/caption]
Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics
MedicalResearch.com: What is the background for this study?
Response: Pegloticase is a PEGylated biologic therapy for patients with uncontrolled gout who have not improved on or could not tolerate conventional urate-lowering therapies. All biologics have the ability to engender anti-drug antibodies (ADAs) and it is known that some patients given pegloticase develop ADAs that cause them to stop treatment prior to receiving a complete course of therapy.
In other rheumatic autoimmune diseases, DMARDs such as methotrexate or azathioprine are used as standard of care to prevent the development of ADAs to biologics. These DMARDs often allow patients to remain on biologic therapies longer and receive the full therapeutic benefits while minimizing adverse events. While pegloticase has been used traditionally as monotherapy, recent case series have demonstrated the therapeutic benefit of immunomodulator co-administration, allowing more patients to receive a full course of pegloticase therapy. Little has been published on how widespread this practice is and whether it has changed over time.
14 Jun EULAR 2020: A National Perspective of Gout and Heart Failure in the US
MedicalResearch.com Interview with: [caption id="attachment_54552" align="alignleft" width="200"] Dr. LaMoreaux[/caption]
Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics
MedicalResearch.com: What is the background for this study?
Response: This is an independent study by Dr. Gurkipal Singh for which Horizon provided support and funding.
Heart failure is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017. Dr. Gurkirpal Singh conducted this analysis on heart failure hospitalization rates in patients with gout in the US to estimate their clinical and economic impact. Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure, but there is little nationwide data on the clinical and economic consequences of these comorbidities.
14 Jun Gout Raises Risk of Amputation, Especially if Combined with Diabetes
MedicalResearch.com Interview with: Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics [caption id="attachment_54552" align="alignleft" width="200"] Dr. LaMoreaux[/caption]
MedicalResearch.com: What is the background for this study?
Response: People with diabetes are known to have an increased risk of undergoing amputation procedures, however it was not known if patients with gout have an elevated independent risk for digit or limb amputations, or whether gout potentiates amputation rates in patients with diabetes. This analysis assessed and compared the rate of amputation procedures conducted in patients with gout, diabetes, both gout and diabetes, and neither gout nor diabetes via examining records from a large US claims database.
14 Jun Uncontrolled Gout: Adding Methotrexate May Allow Patients to Receive Full Course of Krystexxa (Pegloticase)
MedicalResearch.com Interview with:Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics
[caption id="attachment_54552" align="alignleft" width="200"] Dr. LaMoreaux[/caption]
MedicalResearch.com: What is the background for this study?
Response: Pegloticase is an infused biologic approved to treat uncontrolled gout. The drug is highly effective, but patients can develop anti-drug antibodies that may accelerate clearance of pegloticase from the circulation. Randomized clinical trials have shown that 42% of patients treated with bi-weekly pegloticase had a serum uric acid (sUA) below 6.0 mg/dl at 3 and 6 months. Mild-to-moderate immunomodulation has been shown to lower the prevalence of anti-drug antibody formation in patients with other autoimmune diseases (rheumatoid arthritis, Crohn’s disease, juvenile idiopathic arthritis). Case reports and case series in the literature suggest that low to-moderate doses of methotrexate or azathioprine may also decrease anti-drug antibody formation in uncontrolled gout patients treated with pegloticase.
28 Jan Which Blood Pressure Medications Are Better For Patients At Risk of Gout?
Posted at 12:31h
in Author Interviews, Blood Pressure - Hypertension, Brigham & Women's - Harvard, Gout
MedicalResearch.com Interview with:
[caption id="attachment_52991" align="alignleft" width="160"] Dr. Juraschek[/caption]
Stephen P. Juraschek, MD, PhD
Assistant Professor, Harvard Medical School
Beth Israel Deaconess Medical Center
Division of General Medicine, Section for Research
Boston, MA 02215
MedicalResearch.com: What is the background for this study?
Response: Gout is a common complication of blood pressure treatment. Furthermore, 75% of adults with gout have hypertension. There are several classes of medications uses to treat hypertension. While prior studies have reported that calcium channel blockers like amlodipine lower uric acid, its effects on gout risk compared to other common first-line antihypertensive agents are unknown.
10 Nov Renal Transplant Complications in Patients with and without Gout
MedicalResearch.com Interview with: [caption id="attachment_52115" align="alignleft" width="126"] Dr. Francis-Sedlak[/caption]
Megan Francis-Sedlak, PhD
Director of Medical Affairs
Horizon Therapeutics
Lake Forest, Illinois
MedicalResearch.com: What is the background for this study?
Response: The prevalence of gout is more than ten-fold greater among patients who have undergone a kidney transplant than the general population as post-transplant medications to prevent organ rejection can contribute to increased uric acid levels. Overall studies have shown this can lead to higher rates of uncontrolled gout among this vulnerable population with organ transplants.
While we have seen higher mortality rates for patients who have received a kidney transplant with uncontrolled gout compared to kidney transplant patients without uncontrolled gout, we wanted to evaluate the impact of gout on transplant-related complications to better inform patient care and treatment approaches.
30 Sep Heart Disease Linked to Severe Skin Reactions to Gout Medicine Allopurinol
Posted at 19:28h
in Allergies, Author Interviews, Brigham & Women's - Harvard, CMAJ, Dermatology, Heart Disease
MedicalResearch.com Interview with:
[caption id="attachment_51631" align="alignleft" width="120"] Dr. Choi[/caption]
Hyon K. Choi, MD, DrPH
Professor of Medicine, Harvard Medical School
Director, Gout and Crystal Arthropathy Center
Director, Clinical Epidemiology and Health Outcomes
Division of Rheumatology, Allergy, and Immunology
Department of Medicine, Massachusetts General Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Allopurinol is a very common and generally safe medication prescribed to lower serum urate levels, most commonly to patients with gout. However, it can be associated with very rare but serious cutaneous adverse events which includes Stevens-Johnson syndrome and toxic epidermal necrolysis.
Prior studies have demonstrated several risk factors for these types of cutaneous adverse events, including presence of chronic kidney disease, older age, female sex, higher initial dose of allopurinol, and the HLA-B*5801 allele, which is more commonly found in Asians and Black patients. A prior study in Taiwan suggested that heart disease (ischemic heart disease and heart failure) may also be associated with an increased risk of hospitalizations for these cutaneous adverse reactions related to allopurinol.
Thus, our goal was to investigate this association using a general population cohort from Canada. Using Population Data BC, we found that heart disease was in fact independently associated with an increased risk of hospitalization for these cutaneous adverse reactions.
04 Apr Gout Medication Colchicine May Mitigate Inflammatory Effects of Obesity
MedicalResearch.com Interview with: [caption id="attachment_48366" align="alignleft" width="160"] Dr. Yanovski[/caption]
Jack A. Yanovski, MD, PhD
Senior Investigator
Section on Growth and Obesity, DIR, NICHD
National Institutes of Health
Hatfield Clinical Research Center
Bethesda, MD 20892‐1103
MedicalResearch.com: What is the background for this study?
Response: Studies of both mouse models and people suggest that obesity induced inflammation may promote insulin resistance and progression to diabetes. Others have proposed that suppressing this chronic, low level inflammation may slow the onset of diabetes. Nod-like Receptor Family Pyrin Domain Containing 3 (NLRP3) has recently been shown to play a strong role in promoting the inflammatory state in obesity. Colchicine, traditionally used to suppress or prevent inflammation in gout and other disorders is believed to inhibit formation of the NLRP3 inflammasome. Our group hypothesized that colchicine would improve obesity associated inflammation in adults with metabolic syndrome who had not yet developed type 2 diabetes.
30 Aug People With Sleep Apnea At Increased Risk of Gout
MedicalResearch.com Interview with: [caption id="attachment_44241" align="alignleft" width="200"] Dr. Blagojevic-Bucknal[/caption]
Dr M Blagojevic-Bucknal
Senior Lecturer in Statistics Arthritis Research UK Primary Care Centre
Research Institute for Primary Care & Health Sciences
Keele University Staffordshire UK
MedicalResearch.com: What is the background for this study?
Response: Evidence suggests that elevated serum uric acid levels, the cause of gout, are also frequently identified in patients with sleep apnoea However, despite prevalent hyperuricaemia in patients with sleep apnoea, shared risk factors with gout of obesity and alcohol consumption, and research identifying the associations between gout and other co-morbidities, few studies have considered the possibility of an association between sleep apnoea and gout in short and long term.
27 Nov Gout Linked To Raised Risk of Erectile Dysfunction
MedicalResearch.com Interview with: [caption id="attachment_29648" align="alignleft" width="200"]
Dr. Edward Roddy[/caption]
Dr Edward Roddy
Clinical Senior Lecturer in Rheumatology and Honorary Consultant Rheumatologist
Arthritis Research UK Primary Care Centre
Research Institute for Primary Care & Health Sciences
Keele University
Staffordshire UK
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Both gout and erectile dysfunction (ED) are prevalent in the general population, and share some common risk factors such as obesity, alcohol consumption and comorbidity (vascular disease, renal disease etc). We undertook a retrospective cohort study in UK Clinical Practice Research Database, a large longitudinal UK database of UK computerised primary care records, to quantify the risk of incident ED in men with gout. We found that men with gout had 30% greater risk of developing erectile dysfunction than men without gout, after adjusting for confounding variables such as lifestyle factors and comorbidity, although the absolute increased risk was small (0.6%). We did a further analyses including men who already had ED when they were diagnosed with gout, finding that they were also at increased risk of being diagnosed with ED in the year before they developed gout, suggesting that hyperuricaemia, which people can have for decades before developing gout, may be a key reason to explain the increased risk of erectile dysfunction in people with gout. Apparently, some people who make use of content on websites similar to sex-hd.xxx to aid in alleviating their ED.
20 Nov How Does Gout Affect Risk of Colon Cancer?
MedicalResearch.com Interview with: [caption id="attachment_29599" align="alignleft" width="150"]
Dr. Michael Pillinger[/caption]
Michael Pillinger, MD
Professor of Medicine and Biochemistry and Molecular Pharmacology
NYU School of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: We are interested in the co-morbidities of gout and the fact that gout is accompanied by multiple cardiovascular, renal and other events. The implications of gout for cancer are less clear, but the basic biology suggests that either:
1) the acute and chronic inflammation of gout could contribute to a pro-cancer environment;
2) the anti-oxidant effects of urate could have anti-cancer properties;
3) the ability of uric acid to serve as a "danger signal" released from dying cells (potentially including cancer cells" could promote anti-cancer immunity.
The clinical literature is murky at best.
19 Nov Urate Lowering Therapy in Moderate to Severe Chronic Kidney Disease
MedicalResearch.com Interview with: [caption id="attachment_29815" align="alignleft" width="140"]
Dr. Gerald Levy[/caption]
Gerald D. Levy MD
Internal Medicine/Rheumatology
Southern California Kaiser Permanente
Downey, CA
MedicalResearch.com: What are the main findings of your study?
Patients with hyperuricemia and chronic kidney disease (CKD) improve when serum Uric Acid (sUA) is brought below 6mg/dl with urate lowering therapy.
We found a 6% improvement in this group compared to patients not at goal.
More importantly the stage of CKD appears to be important with CKD II showing approximately 3% who improve with nearly 10% of patients improving in the CKD III group.
We did not see benefit in those patients who are stage 4 CKD.
19 Nov No Increased Risk of Chronic Kidney Disease with Allopurinol Use
MedicalResearch.com Interview with: Dr. Ana Beatriz Vargas dos Santos Médica do Serviço de Reumatologia Universidade do Estado do Rio de Janeiro MedicalResearch.com: What is the background for this study? Response: Gout is the most common inflammatory arthritis worldwide and, despite available treatment, the management of gout remains suboptimal. One of the reasons for this suboptimal management of gout is the hesitant use of urate-lowering therapy, including a common reduction in dose or discontinuation of allopurinol in patients with gout who have kidney dysfunction based on the assumption that allopurinol may be worsening kidney function. However, there is no evidence that allopurinol is toxic for the kidneys, and this dose reduction or discontinuation results in more difficult-to-treat gout. Chronic kidney disease stage 3 or above occurs in approximately 20% of people with gout, and there is emerging evidence that urate-lowering therapy may improve kidney function in patients with both gout and CKD. Although CKD is common, most people with gout start out with normal kidney function. Yet, there are limited data regarding the effects of allopurinol on kidney function in such individuals. We, therefore, undertook this study to assess whether people with newly diagnosed gout who are starting allopurinol are at increased risk for developing CKD stage 3 or worse.16 Aug DASH Diet For Hypertension May Also Lower Uric Acid in Gout Patients
Posted at 02:23h
in Author Interviews, Blood Pressure - Hypertension, Gout, Johns Hopkins, Nutrition, Rheumatology
MedicalResearch.com Interview with:
[caption id="attachment_27021" align="alignleft" width="155"]
Dr. Stephen Juraschek[/caption]
Stephen P. Juraschek, MD, PhD
Fellow, Division of General Internal Medicine
Johns Hopkins Hospital
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Diet has long been viewed as an important way to lower uric acid levels to prevent gout attacks; however, there is little evidence about whether a particular dietary pattern might be effective for lowering uric acid. For the first time we show that the DASH diet, an effective diet for lowering blood pressure, it lowers uric acid levels substantially in people with abnormally high uric acid levels.
23 Feb Steroids An Option to NSAIDS for Treatment of Acute Gout
MedicalResearch.com Interview with: [caption id="attachment_21670" align="alignleft" width="120"]
Prof. Timothy Rainer[/caption]
Professor Timothy H Rainer MD MBBCh
Director, Accident & Emergency Medicine Academic Unit
The Chinese University of Hong Kong
Medical Research: What is the background for this study? What are the main findings?
Prof. Rainer: Gout is a type of arthritis characterised by periodic attacks of acute joint swelling and severe pain, and often treated with colchicine or nonsteroidal anti-inflammatory drugs (NSAIDs). Two recent randomized, controlled trials showed that oral prednisolone, a corticosteroid, was as effective as NSAIDs in the treatment of acute gout, but these studies involved small numbers of patients. The researchers investigatedwhether oral prednisolone was as effective and safe as indomethacin (a NSAID) in a larger sample of patients who had acute gout symptoms and who were seen in the emergency department (ED) setting. Patients in both the prednisolone and indomethacin groups had clinically meaningful decreases in their pain levels during the 2 hours they were observed in the ED as well as during the 14-day follow-up period. Both groups had a similar decrease in pain levels. No major adverse events were reported in either group although there were more minor adverse events in the indomethacin group.
10 Nov Acute Gout Episodes Peaks in November
MedicalResearch.com Interview with: Paras Karmacharya, MD Internal Medicine Reading Health System West Reading, PA 19611 Co-Authors: Ranjan Pathak MD, Madan Raj Aryal MD, Smith Giri MD, Anthony A Donato MD MHPE Medical Research: What is the background for this study? Response: Studies describing seasonal variations in acute gouty arthritis note a seasonal trend, but disagree on timing, with most showing a peak in spring months while others showing peaks later in the year. However, serum uric acid (SUA) levels seem to peak in the summer months. This disparity has led to the hypothesis that the flares might be related to factors other than elevated serum uric acid levels. Various theories on the effects of weather and immune system changes on the chronobiology of the equilibrium and precipitation of monosodium urate crystals have been proposed. We aimed to shed light on this question by examining the seasonal variation in the incidence of acute gouty arthritis in the US using a large inpatient database. Medical Research: What are the main findings? Response: We used the Nationwide Inpatient Sample (NIS) database, a large national database that represents 20% of all hospital admissions, to identify adult patients with a primary diagnosis of acute gouty arthritis from 2009-2011 during their hospitalization. A total of 28,172 hospitalizations with primary diagnosis of acute gouty arthritis were reported from 2009-11. The peak incidence of acute gout was seen in the month of November (peak/low ratio 1.34, 95% CI 1.29-1.38, p<0.05) (Figure 1). The highest number of hospitalizations was observed in autumn months, while the lowest incidence was observed in spring (28.12% vs. 23.13%, p<0.001). Medical Research: What should clinicians and patients take away from your report? Response: Unlike previous studies, our analysis found the peak incidence of acute gout in the fall with its peak in the month of November. Various environmental (temperature, humidity, diet, physical activity) and biochemical factors (low cortisol levels, high absolute neutrophil counts and plasminogen activator inhibitor-1) have been implicated for the seasonal variation, but the data on this is conflicting. Whether our findings are reflective of purine and alcohol intake over the US holidays in November and December is a hypothesis that requires further testing.10 Nov Majority of Gout Patients Do Not Achieve Target Uric Acid Level
[caption id="attachment_19091" align="alignleft" width="150"] Dr. Raebel[/caption] MedicalResearch.com Interview with: Marsha A. Raebel, PharmD Senior Investigator Kaiser Permanente Colorado's Institute for Health Research Medical Research: What is the background for this study? What are the main findings? Dr. Raebel: Gout is an inflammatory arthritis that affects at least 7.5 million American adults. A hallmark of gout is...
26 Mar Gout: Using CT Scan to Diagnose Difficult Cases
MedicalResearch.com Interview with:
Tim Bongartz, M.D.
Associate Professor of Medicine
Department of Rheumatology
Mayo Clinic, Minnesota
MedicalResearch.com: What are the main study findings?
Dr. Bongartz: Dual-energy computed tomography (DECT) is an imaging methods that has been in use for many years to classify the material of renal stones. Our study demonstrates that this technology can be useful in identifying monosodium urate deposits in and around joint, allowing to diagnose patients with gout with overall high sensitivity and specificity. Importantly, a stratified analysis of patient subgroups revealed that DECT is less accurate in diagnosing patients with a first flare of gout, emphasizing the importance of careful patient selection when using this new technology. In a "diagnostic-yield" substudy, we explored the question how much DECT could contribute to correctly diagnose patients where clinicians did have a high level of suspicion for gout, but synovial fluid aspiration results came back negative. In about a third of these patients with negative routine testing, we could confirm a diagnosis of gout through use of DECT.
16 Jan Gout: Rising Prevalence and Incidence
Posted at 13:05h
in General Medicine
MedicalResearch.com Interview with:
Weiya Zhang, BPH, MEpi, PhD
Associate Professor & Reader
Division of Rheumatology, Orthopaedics and Dermatology
The University of Nottingham
Clinical Sciences Building City Hospital
Nottingham NG5 1PB
MedicalResearch.com: What are the main findings of the study?
Dr. Zhang: We found the prevalence and incidence of gout keep rising from 1997 to 2012, but the management (percentage of patients treated with the recommended effective drugs) remains poor.
16 Aug Pegloticase aids gout patients not helped by standard treatments
Injections of pegloticase, a modified porcine enzyme, can produce significant and sustained clinical improvements in 2 out of 5 patients with chronic gout that is resistant to conventional therapies, researchers report in the August 17, 2011, issue of JAMA. In two controlled clinical trials, pegloticase rapidly lowered high levels of uric...
28 Jul US Gout prevalence increases over last 2 decades
Posted at 15:19h
in Gout
A new study shows the prevalence of gout in the U.S. has risen over the last twenty years and now affects 8.3 million (4%) Americans. Prevalence of increased uric acid levels (hyperuricemia) also rose, affecting 43.3 million (21%) adults in the U.S. Greater frequency of obesity and hypertension may be...