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Gout: HELP
Articles by Frédéric Lioté
Based on 46 articles published since 2009
(Why 46 articles?)
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Between 2009 and 2019, F. Lioté wrote the following 46 articles about Gout.
 
+ Citations + Abstracts
Pages: 1 · 2
1 Guideline 2016 updated EULAR evidence-based recommendations for the management of gout. 2017

Richette, P / Doherty, M / Pascual, E / Barskova, V / Becce, F / Castañeda-Sanabria, J / Coyfish, M / Guillo, S / Jansen, T L / Janssens, H / Lioté, F / Mallen, C / Nuki, G / Perez-Ruiz, F / Pimentao, J / Punzi, L / Pywell, T / So, A / Tausche, A K / Uhlig, T / Zavada, J / Zhang, W / Tubach, F / Bardin, T. ·AP-HP, hôpital Lariboisière, service de Rhumatologie, F-75010 Paris, France; Inserm, UMR1132, Hôpital Lariboisière, F-75010 Paris, France; Universitè Paris Diderot, Sorbonne Paris Citè, F-75205 Paris, France. · Academic Rheumatology, University of Nottingham, Nottingham, UK. · Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain. · Institute of Rheumatology RAMS, Moscow, Russia. · Department of Diagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland. · AP-HP, Dèpartement d'Epidèmiologie et Recherche Clinique, Hôpital Bichat, Paris, France: APHP, Centre de Pharmacoèpidèmiologie, Paris, France: Univ Paris Diderot, Paris, France: INSERM UMR 1123 ECEVE, Paris, France. · Patient from Nottingham, UK, Paris. · Department of Rheumatology, VieCuri Medical Centre, Venlo, and Scientific IQ HealthCare, Radboud UMC, Nijmegen, The Netherlands. · Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, Netherlands. · Arthritis Research UK Primary Care Centre University of Keele, Keele, UK. · Osteoarticular Research Group, University of Edinburgh, Edinburgh, UK. · Seccion de Rheumatologia, Hospital de Cruces, Baracaldo, Spain. · Rheumatology Unit, Clínica Coração de Jesus, Lisbon, Portugal. · Rheumatology Unit, University of Padova, Padova, Italy. · Service de Rhumatologie, CHUV and Universitè de Lausanne, Lausanne, Switzerland. · Department of Rheumatology, University Clinic at the Technical University Dresden, Germany. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Institute of Rheumatology, Prague, and Department of Rheumatology, First Faculty of Medicine, Charles University in Prague, Czech Republic. ·Ann Rheum Dis · Pubmed #27457514.

ABSTRACT: BACKGROUND: New drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations. METHODS: The EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries. A systematic review of the literature concerning all aspects of gout treatments was performed. Subsequently, recommendations were formulated by use of a Delphi consensus approach. RESULTS: Three overarching principles and 11 key recommendations were generated. For the treatment of flare, colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), oral or intra-articular steroids or a combination are recommended. In patients with frequent flare and contraindications to colchicine, NSAIDs and corticosteroids, an interleukin-1 blocker should be considered. In addition to education and a non-pharmacological management approach, urate-lowering therapy (ULT) should be considered from the first presentation of the disease, and serum uric acid (SUA) levels should be maintained at<6 mg/dL (360 µmol/L) and <5 mg/dL (300 µmol/L) in those with severe gout. Allopurinol is recommended as first-line ULT and its dosage should be adjusted according to renal function. If the SUA target cannot be achieved with allopurinol, then febuxostat, a uricosuric or combining a xanthine oxidase inhibitor with a uricosuric should be considered. For patients with refractory gout, pegloticase is recommended. CONCLUSIONS: These recommendations aim to inform physicians and patients about the non-pharmacological and pharmacological treatments for gout and to provide the best strategies to achieve the predefined urate target to cure the disease.

2 Guideline 2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis. 2012

Khanna, Dinesh / Khanna, Puja P / Fitzgerald, John D / Singh, Manjit K / Bae, Sangmee / Neogi, Tuhina / Pillinger, Michael H / Merill, Joan / Lee, Susan / Prakash, Shraddha / Kaldas, Marian / Gogia, Maneesh / Perez-Ruiz, Fernando / Taylor, Will / Lioté, Frédéric / Choi, Hyon / Singh, Jasvinder A / Dalbeth, Nicola / Kaplan, Sanford / Niyyar, Vandana / Jones, Danielle / Yarows, Steven A / Roessler, Blake / Kerr, Gail / King, Charles / Levy, Gerald / Furst, Daniel E / Edwards, N Lawrence / Mandell, Brian / Schumacher, H Ralph / Robbins, Mark / Wenger, Neil / Terkeltaub, Robert / Anonymous2310738. ·University of Michigan, Ann Arbor, MI, USA. ·Arthritis Care Res (Hoboken) · Pubmed #23024029.

ABSTRACT: -- No abstract --

3 Guideline 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. 2012

Khanna, Dinesh / Fitzgerald, John D / Khanna, Puja P / Bae, Sangmee / Singh, Manjit K / Neogi, Tuhina / Pillinger, Michael H / Merill, Joan / Lee, Susan / Prakash, Shraddha / Kaldas, Marian / Gogia, Maneesh / Perez-Ruiz, Fernando / Taylor, Will / Lioté, Frédéric / Choi, Hyon / Singh, Jasvinder A / Dalbeth, Nicola / Kaplan, Sanford / Niyyar, Vandana / Jones, Danielle / Yarows, Steven A / Roessler, Blake / Kerr, Gail / King, Charles / Levy, Gerald / Furst, Daniel E / Edwards, N Lawrence / Mandell, Brian / Schumacher, H Ralph / Robbins, Mark / Wenger, Neil / Terkeltaub, Robert / Anonymous2300738. ·University of Michigan, Ann Arbor, MI, USA. ·Arthritis Care Res (Hoboken) · Pubmed #23024028.

ABSTRACT: -- No abstract --

4 Editorial New therapeutic approach to hyperuricemia and gout in the light of recommendations. 2016

Lioté, Frédéric. ·Unité Inserm UMR 1132, service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, 2, rue Ambroise-Paré, 75010 Paris, France. Electronic address: frederic.liote@aphp.fr. ·Joint Bone Spine · Pubmed #27085801.

ABSTRACT: -- No abstract --

5 Editorial Managing gout needs more than drugs: 'Il faut le savoir-faire, l'Art et la maniere'. 2013

Lioté, Frédéric / Choi, Hyon. · ·Ann Rheum Dis · Pubmed #23667169.

ABSTRACT: -- No abstract --

6 Review Gout: state of the art after a decade of developments. 2019

Pascart, Tristan / Lioté, Frédéric. ·EA 4490, Lille University, Lille, France. · Service de Rhumatologie, Hôpital Saint-Philibert, Lomme, France. · UFR de Médecine, University of Paris Diderot, USPC, France. · INSERM, UMR 1132 Bioscar (Centre Viggo Petersen), France. · Service de Rhumatologie (Centre Viggo Petersen), Pôle Appareil Locomoteur, Hôpital Lariboisière (AP-HP), Paris, France. ·Rheumatology (Oxford) · Pubmed #29547895.

ABSTRACT: This review article summarizes the relevant English literature on gout from 2010 through April 2017. It emphasizes that the current epidemiology of gout indicates a rising prevalence worldwide, not only in Western countries but also in Southeast Asia, in close relationship with the obesity and metabolic syndrome epidemics. New pathogenic mechanisms of chronic hyperuricaemia focus on the gut (microbiota, ABCG2 expression) after the kidney. Cardiovascular and renal comorbidities are the key points to consider in terms of management. New imaging tools are available, including US with key features and dual-energy CT rendering it able to reveal deposits of urate crystals. These deposits are now included in new diagnostic and classification criteria. Overall, half of the patients with gout are readily treated with allopurinol, the recommended xanthine oxidase inhibitor (XOI), with prophylaxis for flares with low-dose daily colchicine. The main management issues are related to patient adherence, because gout patients have the lowest rate of medication possession ratio at 1 year, but they also include clinical inertia by physicians, meaning XOI dosage is not titrated according to regular serum uric acid level measurements for targeting serum uric acid levels for uncomplicated (6.0 mg/dl) and complicated gout, or the British Society for Rheumatology recommended target (5.0 mg/dl). Difficult-to-treat gout encompasses polyarticular flares, and mostly patients with comorbidities, renal or heart failure, leading to contraindications or side effects of standard-of-care drugs (colchicine, NSAIDs, oral steroids) for flares; and tophaceous and/or destructive arthropathies, leading to switching between XOIs (febuxostat) or to combining XOI and uricosurics.

7 Review Discordant American College of Physicians and international rheumatology guidelines for gout management: consensus statement of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN). 2017

Dalbeth, Nicola / Bardin, Thomas / Doherty, Michael / Lioté, Frédéric / Richette, Pascal / Saag, Kenneth G / So, Alexander K / Stamp, Lisa K / Choi, Hyon K / Terkeltaub, Robert. ·Department of Medicine, University of Auckland, 85 Park Road, Grafton, Auckland 1023, New Zealand. · University Paris Diderot Cité Sorbonne, Service de Rhumatologie, Centre Viggo Petersen, Lariboisière Hospital, INSERM U1132, Paris, France. · Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK. · Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham (UAB), 820 Faculty Office Tower, 510 20th Street, Birmingham, Alabama 35294-3408, USA. · Service of Rheumatology, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Avenue Pierre Decker 4, 1011 Lausanne, Switzerland. · Department of Medicine, University of Otago, Christchurch, P.O. BOX 4345, Christchurch 8140, New Zealand. · Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, 55 Fruit Street, Harvard Medical School, Boston, Massachusetts 02114, USA. · VA San Diego Healthcare System, 111K, 3350 La Jolla Village Drive, San Diego, California 92161, USA. ·Nat Rev Rheumatol · Pubmed #28794514.

ABSTRACT: In November 2016, the American College of Physicians (ACP) published a clinical practice guideline on the management of acute and recurrent gout. This guideline differs substantially from the latest guidelines generated by the American College of Rheumatology (ACR), European League Against Rheumatism (EULAR) and 3e (Evidence, Expertise, Exchange) Initiative, despite reviewing largely the same body of evidence. The Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) convened an expert panel to review the methodology and conclusions of these four sets of guidelines and examine possible reasons for discordance between them. The G-CAN position, presented here, is that the fundamental pathophysiological knowledge underlying gout care, and evidence from clinical experience and clinical trials, supports a treat-to-target approach for gout aimed at lowering serum urate levels to below the saturation threshold at which monosodium urate crystals form. This practice, which is truly evidence-based and promotes the steady reduction in tissue urate crystal deposits, is promoted by the ACR, EULAR and 3e Initiative recommendations. By contrast, the ACP does not provide a clear recommendation for urate-lowering therapy (ULT) for patients with frequent, recurrent flares or those with tophi, nor does it recommend monitoring serum urate levels of patients prescribed ULT. Results from emerging clinical trials that have gout symptoms as the primary end point are expected to resolve this debate for all clinicians in the near term future.

8 Review Treatment of hyperuricemia, gout and other crystalline arthritidies. 2012

Lioté, F. ·Univ Paris Diderot, Sorbonne Paris Cité and AP-HP, Hôpital Lariboisière, Centre Viggo Petersen, Service de Rhumatologie, Paris, France. frederic.liote@lrb.aphp.fr ·Reumatismo · Pubmed #22303534.

ABSTRACT: Gout is a very common joint disease which is due to chronic hyperuricemia and its related articular involvements. Yet it can be cured when appropriately managed. Comprehensive management of gout involves correct identification and addressing all causes of hyperuricemia, treating and preventing attacks of gouty inflammation (using colchicine NSAIDs, and/or steroids), and lowering serum urate (SUA) to an appropriate target level indefinitely. The ideal SUA target is, at a minimum, less than 6 mg/dL (60 mg/L or 360 μmol/L), or even less than 5 mg/dL in patients with tophi. The SUA target should remain at less than 6 mg/dL for long in all gout patients, especially until tophi have resolved. Patient education and adherence to therapy are key point to the optimal management of gout, aspects which are often neglected. Adherence can be monitored in part by continuing, regular assessment of the SUA level. More difficult cases of gout often need a combination of urate lowering therapy (ULT) for both refractory hyperuricemia and chronic tophaceous arthritis. Chronic tophaceous gouty arthropathy which do not respond adequately to optimized oral ULT might benefit from the use of pegloticase, when this is available in, for example, Italy and other European countries. By contrast, in calcium pyrophosphate (CPP) crystal deposition disease (CPPD), as evidenced by pseudo gout attacks or chronic polyarthritis, similar anti-inflammatory strategies have been recommended, but there have as yet been no controlled trials. Of note, there is no treatment for the underlying metabolic disorders able to control the CPPD. Management of crystal-induced arthropathies (CIA) depends not only on clinical expression, namely acute attacks or chronic arthropathy, but also on the underlying metabolic disorder. We will mainly focus on gout as an archetype of CIA.

9 Review [Diagnosis of crystal-induced arthritis]. 2011

Lioté, Frédéric. ·Université Paris-Diderot, Sorbonne Paris-Cité, Paris, France. frederic.liote@lrb.aphp.fr ·Presse Med · Pubmed #21816563.

ABSTRACT: Crystal-induced arthritis (CIA) is easy to diagnose as soon as the physician might suspect the diagnosis. Indeed, CIA can be readily ascertained since one single gold standard is available: identification of microcrystals in synovial fluid or in other materials (tophus, synovial tissue biopsy, periarticular tissues). It is therefore mandatory to perform joint aspiration and to get synovial fluid sample for microscopic examination. Monosodium urate crystals are the key feature of gout, and calcium pyrophosphate (CPP) crystals are associated with CPP disease, also called "chondrocalcinosis" in France. Diagnosis of gout can be readily suspected when considering typical clinical presentations such as podagra, presence of tophi, cardiovascular comorbidities, and diuretics use. Plain radiographs, as long as technical quality is present, are an easy way to suspect and eventually to diagnose CPP disease or apatite deposits in any articular or periarticular site. Joint ultrasonography when performed by skilled physicians can easily help in displaying crystal deposits at the cartilage surface (gout) or within the cartilage (CPP), along with peri-tophaceous inflammatory reaction as evidenced by power Doppler.

10 Review Tophaceous gout: an unusual cause of multiple fractures. 2010

Nguyen, C / Ea, H-K / Palazzo, E / Lioté, F. ·Department of Rheumatology, Centre Viggo Petersen, Lariboisiére Hospital, the Public Assistance Hospital of Paris, (AP-HP), Paris, France. ·Scand J Rheumatol · Pubmed #20132078.

ABSTRACT: OBJECTIVE: Fractures occurring at the site of a tophus have rarely been described in gout. In this paper we review the occurrence, clinical features, and outcome of fractures in tophaceous gout. METHOD: A PubMed search was conducted to identify the relevant literature, following our experience with two patients who developed tophaceous fractures after minor or no trauma. RESULTS: A total of 13 patients were analysed. Eleven cases of tophaceous fracture have been reported since 1950. Common features are: known and long-standing gout with tophi; minor or absence of trauma; specific locations include seven patients with patella bone fractures. Other sites include the cervical spine in two patients, the first and fifth metatarsal, and a phalanx in one patient each, the ilium and pubic bones in one, the medial malleola, and the femoral neck in the latter case. CONCLUSIONS: Monosodium urate (MSU) crystals can contribute to bone lesions by reducing osteoblastic activity and are associated with enhanced osteoclast activity in the vicinity of tophi. Mild trauma triggers MSU crystal release from tophi, resulting in cell activation and production of cytokines and proteases. This could enhance bone erosion leading ultimately to bone fragility and fracture. Our cases exemplify a rare cause of spontaneous fracture. Gouty tophus should be considered when facing a lytic lesion with fracture.

11 Article Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. 2019

Bursill, David / Taylor, William J / Terkeltaub, Robert / Abhishek, Abhishek / So, Alexander K / Vargas-Santos, Ana Beatriz / Gaffo, Angelo Lino / Rosenthal, Ann / Tausche, Anne-Kathrin / Reginato, Anthony / Manger, Bernhard / Sciré, Carlo / Pineda, Carlos / van Durme, Caroline / Lin, Ching-Tsai / Yin, Congcong / Albert, Daniel Arthur / Biernat-Kaluza, Edyta / Roddy, Edward / Pascual, Eliseo / Becce, Fabio / Perez-Ruiz, Fernando / Sivera, Francisca / Lioté, Frédéric / Schett, Georg / Nuki, George / Filippou, Georgios / McCarthy, Geraldine / da Rocha Castelar Pinheiro, Geraldo / Ea, Hang-Korng / Tupinambá, Helena De Almeida / Yamanaka, Hisashi / Choi, Hyon K / Mackay, James / ODell, James R / Vázquez Mellado, Janitzia / Singh, Jasvinder A / Fitzgerald, John D / Jacobsson, Lennart T H / Joosten, Leo / Harrold, Leslie R / Stamp, Lisa / Andrés, Mariano / Gutierrez, Marwin / Kuwabara, Masanari / Dehlin, Mats / Janssen, Matthijs / Doherty, Michael / Hershfield, Michael S / Pillinger, Michael / Edwards, N Lawrence / Schlesinger, Naomi / Kumar, Nitin / Slot, Ole / Ottaviani, Sebastien / Richette, Pascal / MacMullan, Paul A / Chapman, Peter T / Lipsky, Peter E / Robinson, Philip / Khanna, Puja P / Gancheva, Rada N / Grainger, Rebecca / Johnson, Richard J / Te Kampe, Ritch / Keenan, Robert T / Tedeschi, Sara K / Kim, Seoyoung / Choi, Sung Jae / Fields, Theodore R / Bardin, Thomas / Uhlig, Till / Jansen, Tim / Merriman, Tony / Pascart, Tristan / Neogi, Tuhina / Klück, Viola / Louthrenoo, Worawit / Dalbeth, Nicola. ·Department of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia davebursill@bigpond.com. · Department of Medicine, University of Otago, Wellington, New Zealand. · Wellington Regional Rheumatology Unit, Hutt Valley District Health Board, Lower Hutt, New Zealand. · Department of Rheumatology, UCSD/ VA Medical Center, San Diego, California, USA. · Department of Academic Rheumatology, University of Nottingham, Nottingham, UK. · Department of Musculoskeletal Medicine, Service de RMR, Lausanne, Switzerland. · Department of Internal Medicine, Rheumatology Unit, State University of Rio de Janeiro, Rio de Janeiro, Brazil. · Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. · Division of Rheumatology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. · Translational Research Unit, Clement J Zablocki VA Medical Center, Milwaukee, Wisconsin, USA. · Department of Rheumatology, University Hospital 'Carl Gustav Carus' of the Technical University Dresden, Dresden, Germany. · Division of Rheumatology, The Warren Alpert School of Medicine at Brown University, Providence, Rhode Island, USA. · Rheumatology and Immunology, Universität Erlangen-Nürnberg, Erlangen, Germany. · Section of Rheumatology, Department of Medical Sciences, University of Ferrara, Ferrara, Italy. · Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy. · Department of Rheumatology, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico. · Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands. · Division of Allergy, Immunology and Rheumatology, Taichung Veterans General Hospital, Taichung, Taiwan. · Department of Immunology and Dermatology, Henry Ford Health System, Detroit, Michigan, USA. · Department of Rheumatology, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire, USA. · Outpatient Rheumatology Clinic, Nutritional and Lifestyle Medicine Centre, ORLIK, Warsaw, Poland. · Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK. · Department of Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain. · Departamento de Medicina Clínica, Universidad Miguel Hernández, Alicante, Spain. · Department of Diagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland. · Rheumatology Division, Cruces University Hospital, Baracaldo, Spain. · Department of Medicine, University of the Basque Country, Biscay, Spain. · Investigation Group for Arthritis, Biocruces Health Research Institute, Baracaldo, Spain. · Department of Rheumatology, Hospital General Universitario Elda, Elda, Spain. · Department of Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, Paris, France. · Department of Rhumatologie, INSERM UMR-1132 and Université Paris Diderot, Paris, France. · Department of Internal Medicine III, Friedrich-Alexander University Erlangen-Nürnberg and Universitatsklinikum Erlangen, Erlangen, Germany. · Insititute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. · Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland. · School of Medicine and Medical Science, University College Dublin, Dublin, Ireland. · Department of Rheumatology, Hôpital Lariboisière, Paris, France. · Rheumatology, State University of Rio de Janeiro, Rio de Janeiro, Brazil. · Institute of Rheumatology, Tokyo Women's Medical University Hospital, Tokyo, Japan. · School of Medicine, Tokyo Women's Medical University, Tokyo, Japan. · Section of Rheumatology and Clinical Epidemiology, Harvard Medical School and Massachusetts General Hospital, Boston, Massachusetts, USA. · President and CEO, Aristea Therapeutics, San Diego, California, USA. · Division of Rheumatology, University of Nebraska Medical Center, Omaha, Nebraska, USA. · Department of Rheumatology, Hospital General de Mexico and Universidad Nacional Autónoma de México, Mexico City, Mexico. · Department of Medicine at School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA. · Medicine Service, Birmingham Veterans Affairs Medical Center, Birmingham, Alabama, USA. · Division of Epidemiology at School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA. · Department of Medicine/Rheumatology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, California, USA. · Department of Rheumatology and Inflammation Research, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, The Netherlands. · Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts, USA. · Chief Scientific Officer, Corrona, LLC, Southborough, Massachusetts, USA. · Department of Medicine, Otago University, Christchurch, New Zealand. · Department of Rheumatology, Hospital Universitario de Alicante, Alicante, Spain. · Division of Musculoskeletal and Rheumatic Diseases, Instituto Nacional Rehabilitación, México City, México. · Division of Renal Diseases and Hypertension, University of Colorado Denver School of Medicine, Aurora, Colorado, USA. · Department of Cardiology, Toranomon Hospital, Minato-ku, Japan. · Department of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Göteborg, Göteborg, Sweden. · Department of Rheumatology, VieCuri Medical Centre, Venlo, The Netherlands. · Division of Rheumatology, Duke University Medical Center, Durham, North Carolina, USA. · Department of Rheumatology/Medicine, New York University School of Medicine, New York City, New York, USA. · College of Medicine, University of Florida, Gainesville, Florida, USA. · Department of Medicine, Rutgers-Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA. · Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, Detroit, Michigan, USA. · Department of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spinal Disorders, Rigshospitalet Glostrup, Glostrup, Denmark. · Department of Rheumatology, Bichat-Claude Bernard Hospital, University of Sorbonne Paris Cité, Paris, France. · Service de Rhumatologie, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France. · Division of Rheumatology, University of Calgary, Calgary, Alberta, Canada. · Department of Rheumatology, Immunology and Allergy, Canterbury District Health Board, Christchurch, New Zealand. · CEO and CMO, AMPEL BioSolutions, LLC, Charlottesville, Virginia, USA. · School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia. · Department of Rheumatology, University of Michigan, Ann Arbor, Michigan, USA. · Clinic of Rheumatology, University Hospital 'St. Ivan Rilski', Sofia, Bulgaria. · Department of Medicine, University of Otago, Wellington, Wellington, New Zealand. · Division of Renal Diseases and Hypertension, University of Colorado Denver, Denver, Colorado, USA. · Division of Rheumatology, Duke University School of Medicine, Durham, North Carolina, USA. · Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, Massachusetts, USA. · Arthritis Center, Harvard Medical School, Boston, Massachusetts, USA. · Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. · Division of Rheumatology, Department of Internal Medicine, Korea University Medical College, Ansan, South Korea. · Weill Cornell Medical College, Hospital for Special Surgery, New York City, New York, USA. · Department of Rheumatology, Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université de Paris, Paris, France. · Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Department of Biochemistry, University of Otago, Dunedin, New Zealand. · Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lomme, France. · Section of Rheumatology, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA. · Department of Internal Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. · Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand. ·Ann Rheum Dis · Pubmed #31501138.

ABSTRACT: OBJECTIVE: There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout. METHODS: A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions. RESULTS: The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus). CONCLUSION: Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

12 Article Difficult-to-treat gout flares: eligibility for interleukin-1 inhibition in private practice is uncommon according to current EMA approval. 2019

Pascart, Tristan / Norberciak, Laurène / Ea, Hang-Korng / Graf, Sahara / Guggenbuhl, Pascal / Lioté, Frédéric. ·Service de rhumatologie, Hôpital Saint-Philibert, Université de Lille, Lomme, France. · Laboratoire PMOI, Université de Lille, Lille, France. · Département de recherche médicale, Hôpital Saint-Philibert, Université de Lille, Lomme, France. · Sorbonne Paris Cité, Université Paris Diderot, Paris, France. · AP-HP, Hôpital Lariboisière, pôle appareil locomoteur, service de Rhumatologie, centre Viggo Petersen, Paris, France. · Inserm, UMR 1132, centre Viggo Petersen, Hôpital Lariboisière, Paris, France. · Service de rhumatologie, CHU de Rennes, Rennes, France. · Institut NUMECAN, INSERM U 1241, INRA U 1341, Rennes, France. · Université de Rennes 1, Rennes, France. ·Rheumatology (Oxford) · Pubmed #31177284.

ABSTRACT: OBJECTIVE: The objective was to determine the proportion of patients with difficult-to-treat or difficult-to-prevent acute gout attacks eligible for IL-1 inhibition. METHODS: Participants included in the French cross-sectional GOSPEL cohort (n = 1003 gout patients) were examined for contraindications and intolerance to standard of care (SoC) drugs of gout flares (colchicine, non-steroidal anti-inflammatory drugs and systemic glucocorticoids). Patients were classified as definitely eligible for first-line IL-1 inhibition (canakinumab) according to European summary of product characteristics (contraindications/intolerance to SoC and at least three flares per year) without any other anti-inflammatory options (contraindications/intolerance only), or potentially eligible (precaution of use). Eligibility to receive IL-1 during an on-going flare related to insufficient efficacy was assessed (second-line eligibility). RESULTS: Definite first-line eligibility for IL-1 therapy was found in 10 patients (1%) and contraindication to all SoC therapies in nine patients who had presented <3 flares in the past 12 months. At least precaution of use for SoC therapies was noted for 218/1003 patients (21.7%). Of 487 patients experiencing flares at baseline, 114 (23.4%) were still experiencing pain scored ⩾4/10 numeric scale on day 3, one of whom could not receive further SoC drugs. Only nine of them had three or more flares in the past year and were eligible for second-line IL-1 inhibition. CONCLUSION: Despite significant numbers of patients without any SoC anti-inflammatory therapeutic options for gout flares, eligibility for IL-1 inhibition therapy according to current European approval is rare.

13 Article 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout. 2019

Richette, Pascal / Doherty, Michael / Pascual, Eliseo / Barskova, Victoria / Becce, Fabio / Castaneda, Johann / Coyfish, Malcolm / Guillo, Sylvie / Jansen, Tim / Janssens, Hein / Lioté, Frédéric / Mallen, Christian D / Nuki, George / Perez-Ruiz, Fernando / Pimentao, José / Punzi, Leonardo / Pywell, Anthony / So, Alexander K / Tausche, Anne-Kathrin / Uhlig, Till / Zavada, Jakub / Zhang, Weiya / Tubach, Florence / Bardin, Thomas. ·Service de Rhumatologie, Hopital Lariboisiere Centre Viggo Petersen, Paris, France pascal.richette@aphp.fr. · Inserm UMR1132 Bioscar, Universite Paris Diderot UFR de Medecine, Paris, France. · Academic Rheumatology, University of Nottingham, Nottingham, UK. · Rheumatology, Hospital General Universitario de Alicante, Alicante, Spain. · Institute of Rheumatology, RAMS, Moscow, Russian. · Radiology, Lausanne University Hospital, Lausanne, Switzerland. · AP-HP, Hôpital Pitié-Salpêtrière, Département Biostatistique Santé Publique et Information Médicale, Centre de Pharmacoépidémiologie (Cephepi), INSERM, UMR 1123 ECEVE, CIC-1421, Paris, France, Paris, France. · Nottingham, UK. · Département d'Epidémiologie et Recherche Clinique, Paris, France. · Rheumatology, VieCuri, Venlo, Netherlands. · Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. · Department of Rhumatologie, Hôpital Lariboisière, Paris, France. · INSERM UMR-1132 and Université Paris Diderot, Paris, France. · Arthritis Research UK Primary Care Centre, Keele University, Keele, UK. · Centre Molecular Medicine, University of Edinburgh, Edinburgh, Scotland, UK. · Servicio de Reumatologia, Hospital de Cruces, Baracaldo, Spain. · Rheumatology Unit, Clínica Coração de Jesus, Lisbon, Portugal. · Department of Medicine, University of Padua, Padua, Italy. · Musculoskeletal Medicine, Service de RMR, Lausanne, Switzerland. · Department of Internal Medicine, Section of Rheumatology, University Clinic Carl Gustav Carus, Dresden, Saxonia, Germany. · Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Institute of Rheumatology, Prague, Czech Republic, Czech Republic. · Academic Rheumatology, Nottingham University, Nottingham, UK. · Biostatistics and epidemiology, APHP, Hopital Pitié Salpetrière, Paris, France. · Rheumatology, Assistance Publique - Hopitaux de Paris, Paris, France. ·Ann Rheum Dis · Pubmed #31167758.

ABSTRACT: Although gout is the most common inflammatory arthritis, it is still frequently misdiagnosed. New data on imaging and clinical diagnosis have become available since the first EULAR recommendations for the diagnosis of gout in 2006. This prompted a systematic review and update of the 2006 recommendations. A systematic review of the literature concerning all aspects of gout diagnosis was performed. Recommendations were formulated using a Delphi consensus approach. Eight key recommendations were generated. A search for crystals in synovial fluid or tophus aspirates is recommended in every person with suspected gout, because demonstration of monosodium urate (MSU) crystals allows a definite diagnosis of gout. There was consensus that a number of suggestive clinical features support a clinical diagnosis of gout. These are monoarticular involvement of a foot or ankle joint (especially the first metatarsophalangeal joint); previous episodes of similar acute arthritis; rapid onset of severe pain and swelling; erythema; male gender and associated cardiovascular diseases and hyperuricaemia. When crystal identification is not possible, it is recommended that any atypical presentation should be investigated by imaging, in particular with ultrasound to seek features suggestive of MSU crystal deposition (double contour sign and tophi). There was consensus that a diagnosis of gout should not be based on the presence of hyperuricaemia alone. There was also a strong recommendation that all people with gout should be systematically assessed for presence of associated comorbidities and risk factors for cardiovascular disease, as well as for risk factors for chronic hyperuricaemia. Eight updated, evidence-based, expert consensus recommendations for the diagnosis of gout are proposed.

14 Article Adsorption of Proteins on m-CPPD and Urate Crystals Inhibits Crystal-induced Cell Responses: Study on Albumin-crystal Interaction. 2019

Renaudin, Felix / Sarda, Stéphanie / Campillo-Gimenez, Laure / Séverac, Childérick / Léger, Thibaut / Charvillat, Cédric / Rey, Christian / Lioté, Frédéric / Camadro, Jean-Michel / Ea, Hang-Korng / Combes, Christèle. ·Université Paris 7 Denis Diderot, Inserm UMR 1132 Bioscar, Hôpital Lariboisière, Centre Viggo Petersen, Paris 75010, France. felix.renaudin@inserm.fr. · CIRIMAT, Université de Toulouse, CNRS, Université Toulouse 3, Toulouse INP - ENSIACET, Toulouse 31030, France. stephanie.sarda@iut-tlse3.fr. · Université Paris 7 Denis Diderot, Inserm UMR 1132 Bioscar, Hôpital Lariboisière, Centre Viggo Petersen, Paris 75010, France. campillo.laure@gmail.com. · ITAV - CNRS, Université de Toulouse, CNRS, Toulouse 31106, France. childerick.severac@cnrs.fr. · Institut Jacques Monod, UMR7592 CNRS, Université Paris Diderot, Paris 75013, France. thibaut.leger@ijm.fr. · CIRIMAT, Université de Toulouse, CNRS, Université Toulouse 3, Toulouse INP - ENSIACET, Toulouse 31030, France. cedric.charvillat@ensiacet.fr. · CIRIMAT, Université de Toulouse, CNRS, Université Toulouse 3, Toulouse INP - ENSIACET, Toulouse 31030, France. Christian.rey@ensiacet.fr. · Université Paris 7 Denis Diderot, Inserm UMR 1132 Bioscar, Hôpital Lariboisière, Centre Viggo Petersen, Paris 75010, France. frederic.liote@aphp.fr. · Institut Jacques Monod, UMR7592 CNRS, Université Paris Diderot, Paris 75013, France. jean-michel.camadro@ijm.fr. · Université Paris 7 Denis Diderot, Inserm UMR 1132 Bioscar, Hôpital Lariboisière, Centre Viggo Petersen, Paris 75010, France. korngea@yahoo.fr. · CIRIMAT, Université de Toulouse, CNRS, Université Toulouse 3, Toulouse INP - ENSIACET, Toulouse 31030, France. christele.combes@ensiacet.fr. ·J Funct Biomater · Pubmed #31027151.

ABSTRACT: The biological effects and cellular activations triggered by monosodium urate (MSU) and calcium pyrophosphate dihydrate (monoclinic: m-CPPD) crystals might be modulated by protein coating on the crystal surface. This study is aimed at: (i) Identifying proteins adsorbed on m-CPPD crystals, and the underlying mechanisms of protein adsorption, and (ii) to understand how protein coating did modulate the inflammatory properties of m-CPPD crystals. The effects of protein coating were assessed in vitro using primary macrophages and THP1 monocytes. Physico-chemical studies on the adsorption of bovine serum albumin (BSA) upon m-CPPD crystals were performed. Adsorption of serum proteins, and BSA on MSU, as well as upon m-CPPD crystals, inhibited their capacity to induce interleukin-1-β secretions, along with a decreased ATP secretion, and a disturbance of mitochondrial membrane depolarization, suggesting an alteration of NLRP3 inflammasome activation. Proteomic analysis identified numerous m-CPPD-associated proteins including hemoglobin, complement, albumin, apolipoproteins and coagulation factors. BSA adsorption on m-CPPD crystals followed a Langmuir-Freundlich isotherm, suggesting that it could modulate m-CPPD crystal-induced cell responses through crystal/cell-membrane interaction. BSA is adsorbed on m-CPPD crystals with weak interactions, confirmed by the preliminary AFM study, but strong interactions of BSA molecules with each other occurred favoring crystal agglomeration, which might contribute to a decrease in the inflammatory properties of m-CPPD crystals. These findings give new insights into the pathogenesis of crystal-related rheumatic diseases and subsequently may open the way for new therapeutic approaches.

15 Article Reassessing the Safety Profile of Lesinurad in Combination with Xanthine Oxidase Inhibitor Therapy. 2019

Perez-Ruiz, Fernando / Jansen, Tim L / Tausche, Anne-Kathrin / Richette, Pascal / Lioté, Frédéric / So, Alexander K / Stack, Austin. ·Rheumatology Division, Cruces University Hospital, Biocruces Bizkaia Health Research Institute and Medicine Department, Medicine and Nursery School, University of the Basque Country, Bilbao, Vizcaya, Spain. fernando.perezruiz@osakidetza.eus. · Department of Rheumatology, VieCuri MC, Teglseweg 210, 9012 BL, Venlo, The Netherlands. · Department of Rheumatology, University Clinic "Carl Gustav Carus" at the Technical University, Dressden, Germany. · Rheumatology Department and Inserm URM 1132, Centre Viggo Petersen, Hôpital Lariboisière (AP-HP) and Université Paris Diderot, USPC, Paris, France. · University of Lausanne, Lausanne, Switzerland. · Nephrology Division, University Hospital Limerick, Graduate Entry Medical School, Health Research Institute, University of Limerick, Limerick, Ireland. ·Rheumatol Ther · Pubmed #30767124.

ABSTRACT: INTRODUCTION: The rate of adverse renal events has been shown to be higher in patients treated with lesinurad plus a xanthine-oxidase inhibitor (XOI) than in patients treated only with a XOI. We reassessed the risks for various adverse renal events from a different perspective and devised a hypothesis to explain the results. METHODS: We used data from phase 3 trials that were publicly available from the full prescribing information document and estimated the relative risk and the number needed to treat for increased serum creatinine (sCri), renal failure, and renal lithiasis. We examined these risks for each treatment group and the risks stratified by estimated glomerular filtration rate (eGFR). RESULTS: Overall, the relative risk for sCri was > 1.0 with the 400 mg/day dose of lesinurad and higher with the 200 mg/day dose, but it was < 1.0 for both lithiasis and renal failure with the 200 mg/day dose. The relative risk was only statistically significant for sCri with the highest dose of lesinurad. When results stratified by eGFR were considered, the rates of adverse events increased with declining renal function, but the relative risks decreased in parallel, as the rate of adverse events increased much more in the placebo arm than in the active arm (200 mg/day dose). Indeed, the relative risk was only significant for the highest dose of lesinurad in patients with normal eGFR. CONCLUSION: The rate of sCri events was higher in patients treated with both lesinurad and a XOI rather than a XOI alone. This rate was found to increase with decreasing eGFR, but as it does in for both active and placebo arms the relative risk is not different from that observed in the placebo arms in the labeled 200 mg/day dose. This may be explained by pathophysiological changes that develop in chronic kidney disease.

16 Article Ultrasound evaluation in follow-up of urate-lowering therapy in gout: the USEFUL study. 2019

Ebstein, Esther / Forien, Marine / Norkuviene, Eleonora / Richette, Pascal / Mouterde, Gaël / Daien, Claire / Ea, Hang-Korng / Brière, Claire / Lioté, Frédéric / Petraitis, Mykolas / Bardin, Thomas / Ora, Jérémy / Dieudé, Philippe / Ottaviani, Sébastien. ·Rheumatology Department, DHU FIRE, Pôle Infection Immunité, Bichat Hospital (APHP), Paris, France. · Rheumatology Department, Lithuanian University of Health Sciences, Kaunas, Lithuania. · Rheumatology Department, Centre Viggo Petersen, Pole Appareil Locomoteur, Lariboisière Hospital (AP-HP), Inserm UMR 1132, USPC, Paris, France. · Rheumatology Department, Lapeyronie Hospital, EA 2415, Montpellier University, Montpellier, France. ·Rheumatology (Oxford) · Pubmed #30285127.

ABSTRACT: OBJECTIVES: We aimed to determine the ability of ultrasonography (US) to show disappearance of urate deposits in gouty patients requiring urate-lowering therapy (ULT). METHODS: We performed a 6-month multicentre prospective study including patients with: proven gout; presence of US features of gout (tophus and/or double contour sign) at the knee and/or first metatarsophalangeal joints; and no current ULT. US evaluations were performed at baseline and at months 3 and 6 (M3, M6) after starting ULT. Outcomes were: the change in US features of gout at M6 according to final (M6) serum urate (SU) level (high, > 360 μmol/l, i.e. > 6 mg/dl; low, 300-360 μmol/l, i.e. 5-6 mg/dl; very low, < 300 μmol/l, i.e. < 5 mg/dl); and correlation between changed US features and final SU level. RESULTS: We included 79 gouty patients (mean ± s.d., age 61.8 (14) years, 91% males, disease duration 6.3 (6.1) years). Baseline SU level was 530 ± 97 µmol/l (i.e. 8.9 mg/dl ± 1.6mg/dl). At least one US tophus and double contour sign was observed in 74 (94%) and 68 (86%) patients, respectively. Among the 67 completers at M6, 18 and 39 achieved a very low and low SU level, respectively. We found a significant decrease in US features of gout among patients with the lowest SU level (P < 0.001). Final M6 SU level was positively correlated with decreased size of tophus (r = 0.54 [95% CI: 0.34, 0.70], P < 0.0001), and inversely correlated with proportion of double contour sign disappearance (r=-0.59 [-0.74, -0.40]). CONCLUSION: US can show decreased urate deposition after ULT, which is correlated with decreased SU level. The responsiveness of US in gout is demonstrated and can be useful for gout follow-up and adherence to ULT.

17 Article Non-pharmacologic measures for gout management in the prospective GOSPEL cohort: Physicians' practice and patients' compliance profiles. 2019

Chapron, Anthony / Chopin, Typhaine / Esvan, Maxime / Ea, Hang-Korng / Lioté, Frédéric / Guggenbuhl, Pascal. ·Département de médecine générale, université de Rennes, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, CHU de Rennes, 35000 Rennes, France. Electronic address: anthony.chapron@univ-rennes1.fr. · Département de médecine générale, université de Rennes, 35000 Rennes, France. · Département de médecine générale, université de Rennes, 35000 Rennes, France; Inserm, CIC 1414, centre d'investigation clinique de Rennes, CHU de Rennes, 35000 Rennes, France. · Université Paris Diderot USPC, 75010 Paris, France; Inserm UMR1132, hôpital Lariboisière, 75475 Paris cedex 10, France; Service de rhumatologie, hôpital Lariboisière, centre Viggo-Petersen, AP-HP, 75010 Paris, France. · Université de Rennes, 35000 Rennes, France; Service de rhumatologie, CHU de Rennes, 35000 Rennes, France; Inserm, U1241, institut NUMECAN, Inra U 1341, 35000 Rennes, France. ·Joint Bone Spine · Pubmed #30025959.

ABSTRACT: OBJECTIVES: Gout management includes non-pharmacological measures (NPM). The main objective of this study was to describe the NPM proposed by physicians and their implementation by patients after 3-6 months. The secondary objective was to identify NPM compliance profiles among these patients. METHODS: Ancillary observational study using the GOSPEL French cohort of 1003 patients with gout, based on questionnaires for physicians and patients at inclusion and then after 3-6 months. Patients were included by a representative sample of 398 general practitioners (GP) and 109 private-practice rheumatologists. Modifiable risk factors of hyperuricemia and proposed NPM were compared. Patient compliance profiles were identified by multiple correspondence and hierarchical clustering analysis. RESULTS: The study included 630 patients: 80.7% were obese or overweight, 51% reported excessive alcohol consumption. Physicians identified fewer modifiable risk factors than their real prevalence in the cohort. Physicians proposed NPM to 57% of patients, particularly diet modifications (46.4%). Increasing physical activity (P < 0.0001) was the best followed NPM. The physician's influence in the decision of starting NPM was more frequent among GPs' patients (P = 0.01). Three patients' compliance profiles were identified. "Very good responders" (55.8%) implemented all the proposed NPM. "Good responders" (12.7%) had a more severe disease and followed the proposed NPM, but for alcohol consumption. "Bad responders" (31.5%) did not modify their life style: these were older patients with a very recent gout diagnosis. CONCLUSION: More personalized care about NPM requires adapting the practitioner's approach to patients' compliance profiles, especially elderly patients with recent gout.

18 Article Patients With Early-Onset Gout and Development of Earlier Severe Joint Involvement and Metabolic Comorbid Conditions: Results From a Cross-Sectional Epidemiologic Survey. 2019

Pascart, Tristan / Norberciak, Laurène / Ea, Hang-Korng / Guggenbuhl, Pascal / Lioté, Frédéric. ·Université de Lille, EA440, and Hôpital Saint-Philibert, F-59160, Lomme, France. · Université Paris Diderot, Sorbonne Paris Cité, F-75205, AP-HP, Hôpital Lariboisière, Viggo Petersen, F-75010, and INSERM, UMR 1132, Paris, France. · CHU de Rennes, F-35000, Institut Numecan, INSERM U 1241, INRA U 1341, F-35000, and Université de Rennes 1, F-35000, Rennes, France. ·Arthritis Care Res (Hoboken) · Pubmed #30022604.

ABSTRACT: OBJECTIVE: Little is known of the clinical features and comorbidity profile of patients presenting with early-onset gout (EOG), although international guidelines recommend rapid treatment after diagnosis. The objective of this study was to assess specific characteristics and comorbidities of patients with gout who had an early onset. METHODS: Patients from a cross-sectional French national cohort who experienced their first gout flare before age 40 years were included in the EOG group and compared to patients with an onset after age 40 years, the common gout group. RESULTS: A total of 120 patients were included in the EOG group (mean ± SD age 49.5 ± 11.9 years) and 865 patients in the common gout group (mean ± SD age 64.4 ± 10.1 years). Patients with EOG more often presented with a history of polyarticular flares (P < 0.01), but had similar frequency of flares (P = 0.16), gout arthropathy (P = 0.79), and tophi (P = 0.53). Prevalence of each item comprising metabolic syndrome did not differ between groups. In patients with EOG, all cardiovascular comorbidities were diagnosed after gout onset. Greater age, low high-density lipoprotein, and excessive alcohol intake were associated in multivariate analysis with the common gout group, while a familial history of gout, longer duration of urate-lowering treatment, higher serum uric acid levels, and metabolic syndrome were associated with the EOG group. CONCLUSION: Patients with EOG developed slightly more severe joint involvement and earlier metabolic disorders than patients with common gout.

19 Article Gout, Hyperuricemia, and Crystal-Associated Disease Network Consensus Statement Regarding Labels and Definitions for Disease Elements in Gout. 2019

Bursill, David / Taylor, William J / Terkeltaub, Robert / Kuwabara, Masanari / Merriman, Tony R / Grainger, Rebecca / Pineda, Carlos / Louthrenoo, Worawit / Edwards, N Lawrence / Andrés, Mariano / Vargas-Santos, Ana Beatriz / Roddy, Edward / Pascart, Tristan / Lin, Ching-Tsai / Perez-Ruiz, Fernando / Tedeschi, Sara K / Kim, Seoyoung C / Harrold, Leslie R / McCarthy, Geraldine / Kumar, Nitin / Chapman, Peter T / Tausche, Anne-Kathrin / Vazquez-Mellado, Janitzia / Gutierrez, Marwin / da Rocha Castelar-Pinheiro, Geraldo / Richette, Pascal / Pascual, Eliseo / Fisher, Mark C / Burgos-Vargas, Ruben / Robinson, Philip C / Singh, Jasvinder A / Jansen, Tim L / Saag, Kenneth G / Slot, Ole / Uhlig, Tillmann / Solomon, Daniel H / Keenan, Robert T / Scire, Carlo Alberto / Biernat-Kaluza, Edyta / Dehlin, Mats / Nuki, George / Schlesinger, Naomi / Janssen, Matthijs / Stamp, Lisa K / Sivera, Francisca / Reginato, Anthony M / Jacobsson, Lennart / Lioté, Frédéric / Ea, Hang-Korng / Rosenthal, Ann / Bardin, Thomas / Choi, Hyon K / Hershfield, Michael S / Czegley, Christine / Choi, Sung Jae / Dalbeth, Nicola. ·University of Auckland, Auckland, New Zealand, and Adelaide Medical School, University of Adelaide, South Australia, Australia. · University of Otago, Wellington, and Hutt Valley District Health Board, Lower Hutt, New Zealand. · Veterans Affairs Medical Center and University of California, San Diego. · Toranomon Hospital, Tokyo, Japan, and University of Colorado Denver, Aurora. · University of Otago, Dunedin, New Zealand. · Instituto Nacional Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico. · Chiang Mai University, Chiang Mai, Thailand. · University of Florida College of Medicine, Gainesville. · Hospital Universitario de Alicante and Universidad Miguel Hernández, Alicante, Spain. · State University of Rio de Janeiro, Rio de Janeiro, Brazil. · Keele University, Keele, UK. · Lille Catholic University and Saint-Philibert Hospital, Lomme, France. · Taichung Veterans General Hospital, Taichung, Taiwan. · University of the Basque Country, Biscay, and Cruces University Hospital and Biocruces Health Research Institute, Baracaldo, Spain. · Harvard Medical School, and Brigham and Women's Hospital, Boston, Massachusetts. · Corrona, LLC, Waltham, and University of Massachusetts Medical School, Worcester. · Mater Misericordiae University Hospital and University College, Dublin, Ireland. · Henry Ford Hospital, Detroit, Michigan. · Christchurch Hospital, Christchurch, New Zealand. · University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany. · Hospital General de México and Universidad Nacional Autónoma de México, Mexico City, Mexico. · Instituto Nacional Rehabilitación, Mexico City, Mexico. · Hôpital Lariboisière, Assistance Publique-Hopitaux de Paris, and INSERM UMR-1132 and Université Paris Diderot, Paris, France. · Harvard Medical School and Massachusetts General Hospital Boston. · University of Queensland School of Medicine and Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. · Veterans Affairs Medical Center, Birmingham, and University of Alabama at Birmingham. · Viecuri Medical Centre, Venlo, The Netherlands. · University of Alabama at Birmingham. · Rigshospitalet Glostrup, Glostrup, Denmark. · Diakonhjemmet Hospital, Oslo, Norway. · Duke University School of Medicine, Durham, North Carolina. · University of Ferrara, Ferrara, and Italian Society for Rheumatology, Milan, Italy. · ORLIK, Warsaw, Poland. · Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. · University of Edinburgh, Edinburgh, UK. · Rutgers-Robert Wood Johnson Medical School, Piscataway, New Jersey. · University of Otago, Christchurch, New Zealand. · Hospital General Universitario de Elda, Alicante, Spain. · Warren Alpert School of Medicine at Brown University, Providence, Rhode Island. · Medical College of Wisconsin and the Clement J. Zablocki Veterans Affairs Medical Center, Milwaukee. · Duke University Medical Center, Durham, North Carolina. · Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany. · University of California, San Diego, and Korea University Ansan Hospital, Ansan, South Korea. · University of Auckland, Auckland, New Zealand. ·Arthritis Care Res (Hoboken) · Pubmed #29799677.

ABSTRACT: OBJECTIVE: The language currently used to describe gout lacks standardization. The aim of this project was to develop a consensus statement on the labels and definitions used to describe the basic disease elements of gout. METHODS: Experts in gout (n = 130) were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach consensus on the labeling and definitions for the basic disease elements of gout. Disease elements and labels in current use were derived from a content analysis of the contemporary medical literature, and the results of this analysis were used for item selection in the Delphi exercise and face-to-face consensus meeting. RESULTS: There were 51 respondents to the Delphi exercise and 30 attendees at the face-to-face meeting. Consensus agreement (≥80%) was achieved for the labels of 8 disease elements through the Delphi exercise; the remaining 3 labels reached consensus agreement through the face-to-face consensus meeting. The agreed labels were monosodium urate crystals, urate, hyperuric(a)emia, tophus, subcutaneous tophus, gout flare, intercritical gout, chronic gouty arthritis, imaging evidence of monosodium urate crystal deposition, gouty bone erosion, and podagra. Participants at the face-to-face meeting achieved consensus agreement for the definitions of all 11 elements and a recommendation that the label "chronic gout" should not be used. CONCLUSION: Consensus agreement was achieved for the labels and definitions of 11 elements representing the fundamental components of gout etiology, pathophysiology, and clinical presentation. The Gout, Hyperuricemia, and Crystal-Associated Disease Network recommends the use of these labels when describing the basic disease elements of gout.

20 Article Gout furonculosis. 2019

Lioté, Frédéric. ·Université Paris Diderot, UFR de médecine, 75205 Paris cedex 10, France; Service de rhumatologie & Inserm UMR 1132 (centre Viggo Petersen), hôpital Lariboisière, AP-HP, 75010 Paris, France. Electronic address: frederic.liote@aphp.fr. ·Joint Bone Spine · Pubmed #29787811.

ABSTRACT: -- No abstract --

21 Article Cross-sectional survey of the undergraduate rheumatology curriculum in European medical schools: a EULAR School of Rheumatology initiative. 2018

Abhishek, Abhishek / Iagnocco, Annamaria / Bijlsma, J W J / Doherty, Michael / Lioté, Frédéric. ·Academic Rheumatology, Faculty of Medicine and Health Sciences, School of Medicine, University of Nottingham, Nottingham, UK. · Dipartimento di Scienze Cliniche e Biologiche, Università degli Studi di Torino, Turin, Italy. · Department of Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands. · Université Paris Diderot, USPC, UFR de Médecine, Paris, France. · Service de Rhumatologie (centre Viggo Petersen), Hôpital Lariboisière (AP-HP), Paris, France. ·RMD Open · Pubmed #30271621.

ABSTRACT: Objectives: To survey the undergraduate rheumatic and musculoskeletal diseases (RMDs) curriculum content in a sample of medical schools across Europe. Methods: The undergraduate musculoskeletal diseases and disability curriculum of University of Nottingham, UK, was used as a template to develop a questionnaire on curriculum content. The questionnaire elicited binary (yes/no) responses and included the option to provide additional information as free text. The survey was mailed to members of the European League Against Rheumatism (EULAR) School of Rheumatology (Undergraduate Classroom) and to EULAR Standing Committee on Education and Training members in January 2017, with a reminder in February 2017. Results: Responses were received from 21 schools belonging to 11 countries. Assessment of gait, hyperalgesic tender site response and hypermobility were not included in many curricula. Similarly, interpretation of investigations undertaken on synovial fluid was taught in only 16 schools. While disease-modifying anti-rheumatic drugs and biological agents, and urate-lowering treatment were included in the curricula of 20 and 21 institutions, respectively, only curricula from 18 schools included core non-pharmacological interventions. Osteoarthritis, gout, rheumatoid arthritis, spondyloarthropathy, polymyalgia rheumatica and lupus were included in the curriculum of all institutions. However, common RMDs such as calcium pyrophosphate deposition, fibromyalgia, giant cell arteritis and bone and joint infection were included in 19 curricula. Conclusion: This survey highlights areas of similarities and differences in undergraduate curricula across Europe. It is hoped that the results of this survey will catalyse the development and agreement of a minimum core European Curriculum for undergraduate education in RMDs.

22 Article From hyperuricaemia to gout: what are the missing links? 2018

Lioté, Frédéric / Pascart, Tristan. ·Université Paris Diderot, UFR de Médecine, Paris, France. frederic.liote@aphp.fr. · Service de Rhumatologie & INSERM UMR 1132 (Centre Viggo Petersen), Hôpital Lariboisière (AP-HP), Paris, France. frederic.liote@aphp.fr. · EA 4490, Lille University, Lille, France. · Service de Rhumatologie, Hôpital Saint-Philibert, Lomme, France. ·Nat Rev Rheumatol · Pubmed #29921940.

ABSTRACT:

23 Article Effectiveness and safety of anakinra in gout patients with stage 4-5 chronic kidney disease or kidney transplantation: A multicentre, retrospective study. 2018

Loustau, Clotilde / Rosine, Nicolas / Forien, Marine / Ottaviani, Sébastien / Juge, Pierre-Antoine / Lioté, Frédéric / Bardin, Thomas / Richette, Pascal / Dieudé, Philippe / Richez, Christophe / Bannwarth, Bernard / Schaeverbeke, Thierry / Ea, Hang-Korng / Truchetet, Marie-Elise. ·Service de rhumatologie, hôpital Pellegrin, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France. · Service de rhumatologie & Inserm UMR 1132 BIOSCAR, centre Viggo-Petersen, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 75010 Paris, France. · Faculté de médecine, university Paris-Diderot, Sorbonne-Paris-Cité, 75013 Paris, France. · Service de rhumatologie & Inserm UMR 1132 BIOSCAR, centre Viggo-Petersen, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 75010 Paris, France; Faculté de médecine, university Paris-Diderot, Sorbonne-Paris-Cité, 75013 Paris, France. · Faculté de médecine, university Paris-Diderot, Sorbonne-Paris-Cité, 75013 Paris, France; Service de rhumatologie, hôpital Bichat, Assistance publique-Hôpitaux de Paris, 78018 Paris, France. · Service de rhumatologie, hôpital Pellegrin, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Immunoconcept, CNRS UMR 5164, Bordeaux University, Bordeaux 33076, France. · Service de rhumatologie, hôpital Pellegrin, centre hospitalier universitaire de Bordeaux, place Amélie-Raba-Léon, 33076 Bordeaux, France; Immunoconcept, CNRS UMR 5164, Bordeaux University, Bordeaux 33076, France. Electronic address: marie-elise.truchetet@chu-bordeaux.fr. ·Joint Bone Spine · Pubmed #29654950.

ABSTRACT: OBJECTIVES: Interleukin (IL)-1β blocking is effective for the treatment of gout flares and is recommended in patients with contraindications to the standard of care, such as stage 4-5 chronic kidney disease (CKD) patients. However, efficacy and safety data regarding these agents are lacking in this population. We aimed to investigate the efficacy and safety of anakinra for the treatment of gout flares in patients with stage 4-5 CKD or renal transplantation. METHODS: This retrospective study encompassing 3 academic centres included consecutive patients with stage 4-5 CKD or kidney transplantation who received anakinra for the treatment of acute gouty arthritis and completed at least one follow-up visit. Efficacy, occurrence of infection, and renal function variations were recorded. RESULTS: Of the 31 included patients (24 men, mean age 72±11 years), 25 were non-transplant subjects with stage 4-5 CKD (mean estimated glomerular filtration rate, MDRD formula (eGFR) 22.7±6.5mL/min/1.73m CONCLUSION: Anakinra may be a safe therapeutic option for gout patients with advanced CKD. Further randomized controlled studies are required to confirm our results.

24 Article Persistent clinical inertia in gout in 2014: An observational French longitudinal patient database study. 2018

Maravic, Milka / Hincapie, Natalia / Pilet, Simon / Flipo, René-Marc / Lioté, Frédéric. ·Medical Department, AstraZeneca, 31, place des Corolles, 92400 Courbevoie, France. Electronic address: milka.maravic@astrazeneca.com. · Real-World Evidence Solutions, IMS Health, 92100 Boulogne-Billancourt, France. · Department of Rheumatology, University Hospital of Lille, University of Lille 2, 59000 Lille, France. · University Paris Diderot, Sorbonne Paris Cité, 75205 Paris, France; Department of Rheumatology, Hospital Lariboisière, AP-HP, Centre Viggo Petersen, 75010 Paris, France; Inserm, UMR 1132, Hospital Lariboisière, 75010 Paris, France. ·Joint Bone Spine · Pubmed #28478208.

ABSTRACT: OBJECTIVE: To describe the characteristics and management of patients with gout in France during the year 2014. METHODS: Data were obtained from a computerized observational longitudinal patient database of a representative sample of 1200 general practitioners. Patients on urate-lowering treatment and/or colchicine were described by demographics and comorbidities, quality of management indicators (serum uric acid and renal function testing) and treatment (type of urate-lowering treatment, change and dose regimen). RESULTS: We identified 14,400 patients (84.4% men, mean age: 67.5 years) with gout in the database. The most frequent comorbidities were hypertension (70%), dyslipidemia (51%), diabetes (24%) and obesity (23%). The proportion with uric acid and renal function testing data was 32% and 29%, respectively. In gout patients, only 39% had a serum uric acid<6mg/dL. Among treated gout patients, 76% were receiving allopurinol at a mean dose lower than 200mg/d, most without any further change of dose regimen over one year. CONCLUSION: These data outlined the persistence of clinical inertia in 2014 for patients with gout.

25 Article GOSPEL 3: Management of gout by primary-care physicians and office-based rheumatologists in France in the early 21st century - comparison with 2006 EULAR Recommendations. 2017

Goossens, Julia / Lancrenon, Sylvie / Lanz, Sabine / Ea, Hang-Korng / Lambert, Charles / Guggenbuhl, Pascal / Saraux, Alain / Delva, Catherine / Sahbane, Samy / Lioté, Frédéric. ·Service de rhumatologie, hôpital Lariboisière, AP-HP, centre Viggo-Petersen, 75010 Paris, France. · Sylia-Stat, 92340 Bourg-La-Reine, France. · Laboratoires Mayoly-Spindler, 78401 Chatou, France. · Service de rhumatologie, hôpital Lariboisière, AP-HP, centre Viggo-Petersen, 75010 Paris, France; University Paris Diderot, Sorbonne Paris cité, 75205 Paris, France; Inserm, UMR 1132, centre Viggo-Petersen, 75010 Paris, France. · Laboratoires Ipsen Pharma, 92100 Boulogne-Billancourt, France. · Service de rhumatologie, CHU de Rennes, 35203 Rennes, France; Inserm UMR 991, 35000 Rennes, France; Faculté de médecine, université Rennes 1, 35043 Rennes, France. · Service de rhumatologie, CHU de la Cavale-Blanche, université de Bretagne occidentale, 29000 Brest, France. · Vivactis études cliniques, 92400 Courbevoie, France. · Service de rhumatologie, hôpital Lariboisière, AP-HP, centre Viggo-Petersen, 75010 Paris, France; University Paris Diderot, Sorbonne Paris cité, 75205 Paris, France; Inserm, UMR 1132, centre Viggo-Petersen, 75010 Paris, France. Electronic address: frederic.liote@aphp.fr. ·Joint Bone Spine · Pubmed #28411137.

ABSTRACT: INTRODUCTION: In 2006, recommendations about the management of gout were issued by the European League Against Rheumatism (EULAR). The objective of this work was to compare these recommendations to practice patterns of physicians working in private practices in France. METHOD: In a prospective multicenter nationwide study conducted in France, a random sample of primary-care physicians (PCPs) and private-practice rheumatologists (PPRs) was taken in 2009. Each physician included 2 consecutive patients with gout. Each patient was evaluated twice at an interval of 3-6months. Information on EULAR 2006 management modalities were collected in a standardized manner. RESULTS: Of 1003 patients, 771 were evaluated twice. Allopurinol was prescribed to 75.1% of patients in all and was initiated at the first study visit in 44 patients, among whom 19 (43.2%) 19 patients received the recommended starting dosage of 100mg/day. Colchicine therapy to prevent flares was prescribed to 74.3% of patients. Of the 522 patients on allopurinol therapy at the first visit, only 34.5% had serum uric acid levels≤360μmoL/L (mean dosage, 173 mg/day). Excessive dietary intake by patients who were overweight or obese was recorded in 31.5% of patients seen by PCPs and in 19.7% of those seen by OBRs. This finding prompted the delivery of nutritional advice to 45.8% of patients. Discontinuation of excessive alcohol intake was recommended to only 10% of patients. Diuretic therapy discontinuation was feasible in 175 patients but was recommended in only 7 patients. CONCLUSION: Differences between practice patterns and 2006 EULAR recommendations were identified. Simplifying the recommendations and teaching them during medical training and continued medical education may deserve consideration.

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