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Gout: HELP
Articles by Frédéric Lioté
Based on 28 articles published since 2008
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Between 2008 and 2019, F. Lioté wrote the following 28 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 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.

7 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.

8 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.

9 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.

10 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.

11 Article Efficacy and safety of febuxostat in 73 gouty patients with stage 4/5 chronic kidney disease: A retrospective study of 10 centers. 2017

Juge, Pierre-Antoine / Truchetet, Marie-Elise / Pillebout, Evangeline / Ottaviani, Sébastien / Vigneau, Cécile / Loustau, Clotilde / Cornec, Divi / Pascart, Tristan / Snanoudj, Renaud / Bailly, Florian / Cornec-Le Gall, Emilie / Schaeverbeke, Thierry / Saraux, Alain / Dieudé, Philippe / Flipo, René-Marc / Richette, Pascal / Lioté, Frédéric / Bardin, Thomas / Chalès, Gérard / Ea, Hang-Korng. ·Service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 75010 Paris, France. · Service de rhumatologie, CHU de Bordeaux, groupe hospitalier Pellegrin, 33000 Bordeaux, France. · Service de néphrologie, hôpital Saint-Louis, Assistance publique-Hôpitaux de Paris, 75010 Paris, France. · Service de rhumatologie, hôpital Bichat-Claude-Bernard, Assistance publique-Hôpitaux de Paris, 75018 Paris, France. · Service de néphrologie, hôpital Pontchaillou, 35033 Rennes cedex, France. · Service de rhumatologie, hôpital universitaire de Brest, 29200 Brest, France. · Service de rhumatologie, hôpital Saint-Philibert, 59160 Lille, France. · Service de néphrologie, hôpital Necker-Enfants-Malades, Assistance publique-Hôpitaux de Paris, 75015 Paris, France. · Service de rhumatologie, hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, Assistance publique-Hôpitaux de Paris, 75013 Paris, France. · Service de néphrologie, CHRU de Brest, 29200 Brest, France. · Service de rhumatologie, CHU Roger-Salengro, 59160 Lille, France. · Service de rhumatologie, CHU de Rennes, 35033 Rennes cedex, France. · Service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, Assistance publique-Hôpitaux de Paris, 75010 Paris, France; Inserm UMR 1132, université Paris Diderot, Sorbonne Paris Cité, 75475 Paris cedex 10, France. Electronic address: korngea@yahoo.fr. ·Joint Bone Spine · Pubmed #27825577.

ABSTRACT: OBJECTIVES: The allopurinol dose is limited in chronic kidney disease, particularly stage 4/5 chronic kidney disease. Febuxostat has a hepatic metabolism and has been approved without dose adaptation in gouty patients with stage 1-3 chronic kidney disease. We aimed to study the safety and efficacy of febuxostat for stage 4/5 chronic kidney disease. METHODS: In this retrospective study, we included patients with (1) a diagnosis of gout, (2) febuxostat treatment, (3) estimated glomerular filtration rate≤30mL/min/1.73m RESULTS: We included 73 patients (mean age 70.2±11.8, 61 men, 31 with vascular chronic kidney disease and 18 renal transplantation) with gout (baseline serum uric acid level=9.86±2.85mg/dL, mean gout duration 6.2±7.0 years) from 10 academic centers. Comorbidities included cardiac failure (17.8%), hypertension (98.6%), diabetes mellitus (30.1%), dyslipidemia (64.8%) and history of cardiovascular events (38.4%). At the last visit (mean follow-up 68.5±64.8 weeks), the daily dose of febuxostat was 40mg for 7 patients (10.5%), 80mg for 50 (74.6%) and 120mg for 10 (14.9%). Serum uric acid level was<6mg/dL for 49 patients (67%). Renal function improved for 18 patients, was unchanged for 24 and worsened for 31; 19 patients experienced flares and 1 patient, limb edema. CONCLUSION: Febuxostat seemed efficient in gouty patients with stage 4/5 chronic kidney disease. However, safety data were not clear regarding renal function. Larger studies are needed to assess safety.

12 Article Replication of association of the apolipoprotein A1-C3-A4 gene cluster with the risk of gout. 2016

Rasheed, Humaira / Phipps-Green, Amanda J / Topless, Ruth / Smith, Malcolm D / Hill, Catherine / Lester, Susan / Rischmueller, Maureen / Janssen, Matthijs / Jansen, Timothy L / Joosten, Leo A / Radstake, Timothy R / Riches, Philip L / Tausche, Anne-Kathrin / Lioté, Frederic / So, Alexander / van Rij, Andre / Jones, Gregory T / McCormick, Sally P / Harrison, Andrew A / Stamp, Lisa K / Dalbeth, Nicola / Merriman, Tony R. ·Department of Biochemistry, University of Otago, Dunedin, New Zealand Department of Chemistry, University of Engineering and Technology, Lahore, Pakistan. · Department of Biochemistry, University of Otago, Dunedin, New Zealand. · Department of Medicine, Flinders Medical Centre and Repatriation General Hospital, Adelaide. · Rheumatology Department, The Queen Elizabeth Hospital, Woodville South, SA, Australia. · Department of Rheumatology, Rijnstate Hospital, Arnhem. · Department of IQ HealthCare, VieCuri Medical Centre, Venlo. · Department of Internal Medicine and Radboud Institute of Molecular Life Science, Radboud University Medical Center, Nijmegen. · Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands. · Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. · Department of Rheumatology, University Clinic Carl-Gustav-Carus, Dresden, Germany. · INSERM, UMR-S 1132, Hospital Lariboisière University Paris Diderot (UFR de Médecine), Sorbonne Paris Cité, Paris, F-75205, France. · DAL, Service of Rheumatology, Laboratory of Rheumatology, University of Lausanne, CHUV, Nestlé 05-5029, Lausanne, Switzerland. · Department of Surgery, University of Otago, Dunedin. · Department of Medicine, University of Otago, Wellington. · Department of Medicine, University of Otago, Christchurch. · Department of Medicine, University of Auckland, Auckland, New Zealand. · Department of Biochemistry, University of Otago, Dunedin, New Zealand tony.merriman@otago.ac.nz. ·Rheumatology (Oxford) · Pubmed #27094595.

ABSTRACT: OBJECTIVE: Gout is associated with dyslipidaemia. Association of the apolipoprotein A1-C3-A4 gene cluster with gout has previously been reported in a small study. To investigate a possible causal role for this locus in gout, we tested the association of genetic variants from APOA1 (rs670) and APOC3 (rs5128) with gout. METHODS: We studied data for 2452 controls and 2690 clinically ascertained gout cases of European and New Zealand Polynesian (Māori and Pacific) ancestry. Data were also used from the publicly available Atherosclerosis Risk in Communities study (n = 5367) and the Framingham Heart Study (n = 2984). Multivariate adjusted logistic and linear regression was used to test the association of single-nucleotide polymorphisms with gout risk, serum urate, triglyceride and high-density lipoprotein cholesterol (HDL-C). RESULTS: In Polynesians, the T-allele of rs670 (APOA1) increased (odds ratio, OR = 1.53, P = 4.9 × 10(-6)) and the G-allele of rs5128 (APOC3) decreased the risk of gout (OR = 0.86, P = 0.026). In Europeans, there was a strong trend to a risk effect of the T-allele for rs670 (OR = 1.11, P = 0.055), with a significant protective effect of the G-allele for rs5128 being observed after adjustment for triglycerides and HDL-C (OR = 0.81, P = 0.039). The effect at rs5128 was specific to males in both Europeans and Polynesians. Association in Polynesians was independent of any effect of rs670 and rs5128 on triglyceride and HDL-C levels. There was no evidence for association of either single-nucleotide polymorphism with serum urate levels (P ⩾ 0.10). CONCLUSION: Our data, replicating a previous study, supports the hypothesis that the apolipoprotein A1-C3-A4 gene cluster plays a causal role in gout.

13 Article GOSPEL 2 - Colchicine for the treatment of gout flares in France - a GOSPEL survey subgroup analysis. Doses used in common practices regardless of renal impairment and age. 2016

Pascart, Tristan / Lancrenon, Sylvie / Lanz, Sabine / Delva, Catherine / Guggenbuhl, Pascal / Lambert, Charles / Aubert, Jean-Pierre / Saraux, Alain / Ea, Hang-Korng / Lioté, Frédéric. ·Service de rhumatologie, université catholique de Lille, hôpital Saint-Philibert, 59160 Saint-Philibert, France; Service de rhumatologie, université Lille 2, hôpital Roger-Salengro, 59037 Lille, France. · Sylia-Stat, 92340 Bourg-La-Reine, France. · Laboratoires Mayoly-Spindler, 78400 Chatou, France. · Service de rhumatologie, CHU de Rennes, 35000 Rennes, France; Inserm UMR 991, 35000 Rennes, France; Université de Rennes 1, 35000 Rennes, France. · Laboratoires Ipsen Pharma, 92100 Boulogne, France. · Université Paris-Diderot, Sorbonne Paris-Cité, EA recherche clinique coordonnée ville-hôpital, méthodologies et société (REMES), 75018 Paris, France. · Service de rhumatologie, université de Bretagne Occidentale, CHU de la Cavale-Blanche, 29200 Brest, France. · Université Paris Diderot, Sorbonne Paris Cité, 75205 Paris, France; Pôle appareil locomoteur, service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm, UMR 1132, hôpital Lariboisière, 75010 Paris, France. · Université Paris Diderot, Sorbonne Paris Cité, 75205 Paris, France; Pôle appareil locomoteur, service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm, UMR 1132, hôpital Lariboisière, 75010 Paris, France. Electronic address: frederic.liote@lrb.aphp.fr. ·Joint Bone Spine · Pubmed #26919801.

ABSTRACT: OBJECTIVES: The objective of this sub-study was to assess the use of colchicine for the treatment of gout flares in real life conditions in the GOSPEL cohort following the 2006 EULAR recommendations for gout management. METHODS: This national cross-sectional epidemiologic survey included outpatients with gout suffering from acute flare followed by randomly selected primary care physicians (n=398) and private practice rheumatologists (n=109) between October 2008 and September 2009 in France. Data regarding patient characteristics and treatment prescription was collected by each physician. Glomerular filtration rate (eGFR) was estimated using the Cockroft-Gault formula. Patients included in the survey for a gout flare filled in a specific self-questionnaire including colchicine effective intake and pain relief (numeric scale). RESULTS: This analysis focused on the 349 patients presenting with gout flare and treated with colchicine. Mean (±SD) prescribed dose of colchicine was 2.8 (±0.7) mg within the first 24hours and the cumulative dose over the first three days of treatment was 6.9 (±1.8) mg. Patients with mild decline in eGFR (eDFG 60-80mL/min) were prescribed an average initial dose of 2.8mg (±0.8) mg (n=58), 2.7 (±0.8) mg in chronic kidney disease (CKD) stage 3 (n=43) and 2.5 (±0.7) mg in CKD stage 4 (n=2). Cumulative doses of colchicine did not take into account either renal impairment or age. CONCLUSIONS: This study draws attention to some misuse of colchicine in daily practice and the prescription of excessive doses especially in case of renal impairment. eGFR should be enforced in daily practice.

14 Article The Toll-Like Receptor 4 (TLR4) Variant rs2149356 and Risk of Gout in European and Polynesian Sample Sets. 2016

Rasheed, Humaira / McKinney, Cushla / Stamp, Lisa K / Dalbeth, Nicola / Topless, Ruth K / Day, Richard / Kannangara, Diluk / Williams, Kenneth / Smith, Malcolm / Janssen, Matthijs / Jansen, Tim L / Joosten, Leo A / Radstake, Timothy R / Riches, Philip L / Tausche, Anne-Kathrin / Lioté, Frederic / Lu, Leo / Stahl, Eli A / Choi, Hyon K / So, Alexander / Merriman, Tony R. ·Department of Biochemistry, University of Otago, Dunedin, New Zealand. · University of Engineering and Technology, Lahore, Pakistan. · Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand. · Department of Medicine, University of Auckland, Auckland, New Zealand. · School of Medical Sciences, University of New South Wales, Sydney, Australia. · Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia. · Department of Medicine, Flinders Medical Centre and Repatriation General Hospital, Adelaide, Australia. · Department of Rheumatology, Rijnstate Hospital, Arnhem, The Netherlands. · Department of IQ HealthCare, VieCuri Medical Centre, Venlo, The Netherlands. · Department of Internal Medicine and Radboud Institute of Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands. · Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, Department of Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands. · Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom. · Department of Rheumatology, University Clinic "Carl-Gustav-Carus", Dresden, Germany. · INSERM, UMR-S 1132, Hospital Lariboisière, Paris, France. · University Paris Diderot (UFR de Médecine), Sorbonne Paris Cité, Paris, France. · Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America. · Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America. · DAL, Service of Rheumatology, Laboratory of Rheumatology, University of Lausanne, CHUV, Nestlé, Lausanne, Switzerland. ·PLoS One · Pubmed #26808548.

ABSTRACT: Deposition of crystallized monosodium urate (MSU) in joints as a result of hyperuricemia is a central risk factor for gout. However other factors must exist that control the progression from hyperuricaemia to gout. A previous genetic association study has implicated the toll-like receptor 4 (TLR4) which activates the NLRP3 inflammasome via the nuclear factor-κB signaling pathway upon stimulation by MSU crystals. The T-allele of single nucleotide polymorphism rs2149356 in TLR4 is a risk factor associated with gout in a Chinese study. Our aim was to replicate this observation in participants of European and New Zealand Polynesian (Māori and Pacific) ancestry. A total of 2250 clinically-ascertained prevalent gout cases and 13925 controls were used. Non-clinically-ascertained incident gout cases and controls from the Health Professional Follow-up (HPFS) and Nurses Health Studies (NHS) were also used. Genotypes were derived from genome-wide genotype data or directly obtained using Taqman. Logistic regression analysis was done including age, sex, diuretic exposure and ancestry as covariates as appropriate. The T-allele increased the risk of gout in the clinically-ascertained European samples (OR = 1.12, P = 0.012) and decreased the risk of gout in Polynesians (OR = 0.80, P = 0.011). There was no evidence for association in the HPFS or NHS sample sets. In conclusion TLR4 SNP rs2143956 associates with gout risk in prevalent clinically-ascertained gout in Europeans, in a direction consistent with previously published results in Han Chinese. However, with an opposite direction of association in Polynesians and no evidence for association in a non-clinically-ascertained incident gout cohort this variant should be analysed in other international gout genetic data sets to determine if there is genuine evidence for association.

15 Article Prevalence of Gout in the Adult Population of France. 2016

Bardin, Thomas / Bouée, Stéphane / Clerson, Pierre / Chalès, Gérard / Flipo, René-Marc / Lioté, Frédéric / Perez, Vincent / Poiraud, Thierry / Schaeverbeke, Thierry / Richette, Pascal. ·Assistance Publique Hôpitaux de Paris, Hôpital Lariboisière, F-75010, University Paris Diderot, Sorbonne Paris Cité, F-75205, and INSERM, UMR 1132, F-75010, Paris, France. · Cemka Statistics, Bourg La Reine, France. · Orgamétrie Biostatistiques, Roubaix, France. · CHU Rennes, Hôpital Sud, and University of Rennes, Rennes, France. · University of Lille, Lille, France. · Ménarini France, Rungis, France. · Hôpital Pellegrin 33076 and University Bordeaux, Segalen, France. ·Arthritis Care Res (Hoboken) · Pubmed #26234279.

ABSTRACT: OBJECTIVE: To estimate adult gout prevalence in France. METHODS: We used a previously established phone questionnaire that allowed for classifying patients as gouty or nongouty by 2 logistic regression models and 1 classification and regression tree (CART) model, the sensitivity and specificity of which were all more than 80%. The full questionnaire was administered by phone to subjects who acknowledged present or past nontraumatic acute pain in a peripheral joint, the others being classified as nongouty. A random sample of adults residing in France was derived from the national telephone directory (home and mobile) by the quota method and further redressed to match the French population. The target size for the interview survey conducted in March and June 2013 was 10,000 participants. RESULTS: We interviewed 10,026 participants. All 3 models (2 logistic regression models and a CART model) converged to an estimated gout prevalence of 0.9%. This prevalence was lower than that estimated by self-reporting only (3.7% [95% confidence interval 3.3-4.1]). The prevalence was higher for men than women and increased with age but did not differ by area of France. CONCLUSION: Gout prevalence in the adult population of France in 2013 was estimated at 0.9%. Studies using self-reporting only might overestimate the prevalence.

16 Article Multiplicative interaction of functional inflammasome genetic variants in determining the risk of gout. 2015

McKinney, Cushla / Stamp, Lisa K / Dalbeth, Nicola / Topless, Ruth K / Day, Richard O / Kannangara, Diluk Rw / Williams, Kenneth M / Janssen, Matthijs / Jansen, Timothy L / Joosten, Leo A / Radstake, Timothy R / Riches, Philip L / Tausche, Anne-Kathrin / Lioté, Frederic / So, Alexander / Merriman, Tony R. ·Department of Biochemistry, University of Otago, Box 56, Dunedin, 9054, New Zealand. cushla.mckinney@otago.ac.nz. · Department of Medicine, University of Otago, Christchurch, PO Box 4345, Christchurch, New Zealand. lisa.stamp@cdhb.govt.nz. · Department of Medicine, University of Auckland, Auckland, New Zealand. n.dalbeth@auckland.ac.nz. · Department of Biochemistry, University of Otago, Box 56, Dunedin, 9054, New Zealand. ruth.topless@otago.ac.nz. · School of Medical Sciences, University of New South Wales, Sydney, Australia. r.day@unsw.edu.au. · Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia. r.day@unsw.edu.au. · School of Medical Sciences, University of New South Wales, Sydney, Australia. r.kannangara@unsw.edu.au. · Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia. r.kannangara@unsw.edu.au. · School of Medical Sciences, University of New South Wales, Sydney, Australia. ken.williams@unsw.edu.au. · Department of Clinical Pharmacology & Toxicology, St Vincent's Hospital, Sydney, Australia. ken.williams@unsw.edu.au. · Department of Rheumatology, Rijnstate Hospital, Arnhem, The Netherlands. matthijs.janssen@rijnstate.nl. · Department of IQ HealthCare, VieCuri Medical Centre, Venlo, The Netherlands. tim.jansen@radboudumc.ml. · Scientific Institute of Quality in HealthCare, Radboud University Medical Centre, Nijmegen, The Netherlands. tim.jansen@radboudumc.ml. · Department of Internal Medicine and Radboud Institute of Molecular Life Science, Radboud University Medical Center, Nijmegen, The Netherlands. l.joosten@aig.umcn.nl. · Department of Rheumatology and Clinical Immunology, Laboratory of Translational Immunology, University Medical Centre Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands. tradstake73@googlemail.com. · Department of Immunology, University Medical Centre Utrecht, PO Box 85500, 3508, GA, Utrecht, The Netherlands. tradstake73@googlemail.com. · Rheumatic Diseases Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. priches@staffmail.ed.ac.uk. · Department of Rheumatology, University Clinic Carl-Gustav-Carus", Dresden, Germany. anne-kathrin.tausche@uniklinikum-dresden.de. · INSERM, UMR-S 1132, Hospital Lariboisière, F-75010, Paris, France. frederic.liote@lrb.aphp.fr. · University Paris Diderot (UFR de Médecine), Sorbonne Paris Cité, F-75205, Paris, France. frederic.liote@lrb.aphp.fr. · DAL, Service of Rheumatology, Laboratory of Rheumatology, University of Lausanne, CHUV, Nestlé 05-5029, 1011, Lausanne, Switzerland. alexanderkai-lik.so@chuv.ch. · Department of Biochemistry, University of Otago, Box 56, Dunedin, 9054, New Zealand. tony.merriman@otago.ac.nz. ·Arthritis Res Ther · Pubmed #26462562.

ABSTRACT: INTRODUCTION: The acute gout flare results from a localised self-limiting innate immune response to monosodium urate (MSU) crystals deposited in joints in hyperuricaemic individuals. Activation of the caspase recruitment domain-containing protein 8 (CARD8) NOD-like receptor pyrin-containing 3 (NLRP3) inflammasome by MSU crystals and production of mature interleukin-1β (IL-1β) is central to acute gouty arthritis. However very little is known about genetic control of the innate immune response involved in acute gouty arthritis. Therefore our aim was to test functional single nucleotide polymorphism (SNP) variants in the toll-like receptor (TLR)-inflammasome-IL-1β axis for association with gout. METHODS: 1,494 gout cases of European and 863 gout cases of New Zealand (NZ) Polynesian (Māori and Pacific Island) ancestry were included. Gout was diagnosed by the 1977 ARA gout classification criteria. There were 1,030 Polynesian controls and 10,942 European controls including from the publicly-available Atherosclerosis Risk in Communities (ARIC) and Framingham Heart (FHS) studies. The ten SNPs were either genotyped by Sequenom MassArray or by Affymetrix SNP array or imputed in the ARIC and FHS datasets. Allelic association was done by logistic regression adjusting by age and sex with European and Polynesian data combined by meta-analysis. Sample sets were pooled for multiplicative interaction analysis, which was also adjusted by sample set. RESULTS: Eleven SNPs were tested in the TLR2, CD14, IL1B, CARD8, NLRP3, MYD88, P2RX7, DAPK1 and TNXIP genes. Nominally significant (P < 0.05) associations with gout were detected at CARD8 rs2043211 (OR = 1.12, P = 0.007), IL1B rs1143623 (OR = 1.10, P = 0.020) and CD14 rs2569190 (OR = 1.08; P = 0.036). There was significant multiplicative interaction between CARD8 and IL1B (P = 0.005), with the IL1B risk genotype amplifying the risk effect of CARD8. CONCLUSION: There is evidence for association of gout with functional variants in CARD8, IL1B and CD14. The gout-associated allele of IL1B increases expression of IL-1β - the multiplicative interaction with CARD8 would be consistent with a synergy of greater inflammasome activity (resulting from reduced CARD8) combined with higher levels of pre-IL-1β expression leading to increased production of mature IL-1β in gout.

17 Article 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. 2015

Neogi, Tuhina / Jansen, Tim L Th A / Dalbeth, Nicola / Fransen, Jaap / Schumacher, H Ralph / Berendsen, Dianne / Brown, Melanie / Choi, Hyon / Edwards, N Lawrence / Janssens, Hein J E M / Lioté, Frédéric / Naden, Raymond P / Nuki, George / Ogdie, Alexis / Perez-Ruiz, Fernando / Saag, Kenneth / Singh, Jasvinder A / Sundy, John S / Tausche, Anne-Kathrin / Vaquez-Mellado, Janitzia / Yarows, Steven A / Taylor, William J. ·Boston University School of Medicine, Boston, Massachusetts, USA. · Viecuri Medical Center, Venlo, The Netherlands Radboud University Medical Center, Nijmegen, The Netherlands. · University of Auckland, Auckland, New Zealand. · Radboud University Medical Center, Nijmegen, The Netherlands. · University of Pennsylvania, Philadelphia, Pennsylvania, USA. · University of Otago, Wellington, New Zealand. · University of Florida, Gainesville, Florida, USA. · INSERM UMR 1132, Hôpital Lariboisière, AP-HP, and Université Paris Diderot, Sorbonne Paris Cité, Paris, France. · McMaster University Medical Centre, Hamilton, Ontario, Canada. · University of Edinburgh, Edinburgh, UK. · Hospital Universitario Cruces and BioCruces Health Research Institute, Vizcaya, Spain. · University of Alabama at Birmingham, Birmingham, Alabama, USA. · Birmingham VA Medical Center and University of Alabama at Birmingham, and Mayo Clinic College of Medicine, Rochester, Minnesota, USA. · Duke University and Duke University Medical Center, Durham, North Carolina, USA Gilead Sciences, Foster City, California, USA. · University Hospital Carl Gustav Carus, Dresden, Germany. · Hospital General de Mexico, Mexico City, Mexico. · University of Michigan Health System, Chelsea. ·Ann Rheum Dis · Pubmed #26359487.

ABSTRACT: OBJECTIVE: Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. METHODS: An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multi-criterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. RESULTS: The entry criterion for the new classification criteria requires the occurrence of at least one episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (ie, synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy CT, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). CONCLUSIONS: The new classification criteria, developed using a data-driven and decision-analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout.

18 Article 2015 Gout Classification Criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. 2015

Neogi, Tuhina / Jansen, Tim L Th A / Dalbeth, Nicola / Fransen, Jaap / Schumacher, H Ralph / Berendsen, Dianne / Brown, Melanie / Choi, Hyon / Edwards, N Lawrence / Janssens, Hein J E M / Lioté, Frédéric / Naden, Raymond P / Nuki, George / Ogdie, Alexis / Perez-Ruiz, Fernando / Saag, Kenneth / Singh, Jasvinder A / Sundy, John S / Tausche, Anne-Kathrin / Vazquez-Mellado, Janitzia / Yarows, Steven A / Taylor, William J. ·Boston University School of Medicine, Boston, Massachusetts. · Viecuri Medical Center, Venlo, The Netherlands, and Radboud University Medical Center, Nijmegen, The Netherlands. · University of Auckland, Auckland, New Zealand. · Radboud University Medical Center, Nijmegen, The Netherlands. · University of Pennsylvania, Philadelphia. · University of Otago, Wellington, New Zealand. · University of Florida, Gainesville. · Frédéric Lioté, MD, PhD: INSERM UMR 1132, Hôpital Lariboisière, AP-HP, and Université Paris Diderot, Sorbonne Paris Cité, Paris, France. · McMaster University Medical Centre, Hamilton, Ontario, Canada. · University of Edinburgh, Edinburgh, UK. · Hospital Universitario Cruces and BioCruces Health Research Institute, Vizcaya, Spain. · University of Alabama at Birmingham. · Birmingham VA Medical Center and University of Alabama at Birmingham, and Mayo Clinic College of Medicine, Rochester, Minnesota. · Gilead Sciences, Foster City, California). · University Hospital Carl Gustav Carus, Dresden, Germany. · Hospital General de Mexico, Mexico City, Mexico. · University of Michigan Health System, Chelsea. ·Arthritis Rheumatol · Pubmed #26352873.

ABSTRACT: OBJECTIVE: Existing criteria for the classification of gout have suboptimal sensitivity and/or specificity, and were developed at a time when advanced imaging was not available. The current effort was undertaken to develop new classification criteria for gout. METHODS: An international group of investigators, supported by the American College of Rheumatology and the European League Against Rheumatism, conducted a systematic review of the literature on advanced imaging of gout, a diagnostic study in which the presence of monosodium urate monohydrate (MSU) crystals in synovial fluid or tophus was the gold standard, a ranking exercise of paper patient cases, and a multicriterion decision analysis exercise. These data formed the basis for developing the classification criteria, which were tested in an independent data set. RESULTS: The entry criterion for the new classification criteria requires the occurrence of at least 1 episode of peripheral joint or bursal swelling, pain, or tenderness. The presence of MSU crystals in a symptomatic joint/bursa (i.e., synovial fluid) or in a tophus is a sufficient criterion for classification of the subject as having gout, and does not require further scoring. The domains of the new classification criteria include clinical (pattern of joint/bursa involvement, characteristics and time course of symptomatic episodes), laboratory (serum urate, MSU-negative synovial fluid aspirate), and imaging (double-contour sign on ultrasound or urate on dual-energy computed tomography, radiographic gout-related erosion). The sensitivity and specificity of the criteria are high (92% and 89%, respectively). CONCLUSION: The new classification criteria, developed using a data-driven and decision analytic approach, have excellent performance characteristics and incorporate current state-of-the-art evidence regarding gout.

19 Article Identification of patients with gout: elaboration of a questionnaire for epidemiological studies. 2015

Richette, P / Clerson, P / Bouée, S / Chalès, G / Doherty, M / Flipo, R M / Lambert, C / Lioté, F / Poiraud, T / Schaeverbeke, T / Bardin, T. ·Université Paris Diderot, UFR médicale, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisiére, Fédération de Rhumatologie, Paris, Cedex, France INSERM 1132, Université Paris-Diderot, Hôpital Lariboisière, Paris, France. · Orgamétrie Biostatistiques, Roubaix, France. · Cemka-Eval, Bourg La Reine, France. · Service de rhumatologie, Hôpital Sud, CHU Rennes, Université de Rennes-1, Rennes, Cedex, France. · Academic Rheumatology, University of Nottingham, City Hospital, Nottingham, UK. · Service de Rhumatologie, Université de Lille 2, Hôpital Roger-Salengro, CHRU de Lille. · Département médical, Ipsen, Boulogne, France. · Département médical, Ménarini, Rungis, France. · Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, place Amélie-Raba-Léon, Bordeaux, France. · Université Paris Diderot, UFR médicale, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisiére, Fédération de Rhumatologie, Paris, Cedex, France. ·Ann Rheum Dis · Pubmed #24796335.

ABSTRACT: OBJECTIVES: In France, the prevalence of gout is currently unknown. We aimed to design a questionnaire to detect gout that would be suitable for use in a telephone survey by non-physicians and assessed its performance. METHODS: We designed a 62-item questionnaire covering comorbidities, clinical features and treatment of gout. In a case-control study, we enrolled patients with a history of arthritis who had undergone arthrocentesis for synovial fluid analysis and crystal detection. Cases were patients with crystal-proven gout and controls were patients who had arthritis and effusion with no monosodium urate crystals in synovial fluid. The questionnaire was administered by phone to cases and controls by non-physicians who were unaware of the patient diagnosis. Logistic regression analysis and classification and regression trees were used to select items discriminating cases and controls. RESULTS: We interviewed 246 patients (102 cases and 142 controls). Two logistic regression models (sensitivity 88.0% and 87.5%; specificity 93.0% and 89.8%, respectively) and one classification and regression tree model (sensitivity 81.4%, specificity 93.7%) revealed 11 informative items that allowed for classifying 90.0%, 88.8% and 88.5% of patients, respectively. CONCLUSIONS: We developed a questionnaire to detect gout containing 11 items that is fast and suitable for use in a telephone survey by non-physicians. The questionnaire demonstrated good properties for discriminating patients with and without gout. It will be administered in a large sample of the general population to estimate the prevalence of gout in France.

20 Article Efficacy of anakinra in gouty arthritis: a retrospective study of 40 cases. 2013

Ottaviani, Sébastien / Moltó, Anna / Ea, Hang-Korng / Neveu, Séverine / Gill, Ghislaine / Brunier, Lauren / Palazzo, Elisabeth / Meyer, Olivier / Richette, Pascal / Bardin, Thomas / Allanore, Yannick / Lioté, Frédéric / Dougados, Maxime / Dieudé, Philippe. · ·Arthritis Res Ther · Pubmed #24432362.

ABSTRACT: INTRODUCTION: Gout is a common arthritis that occurs particularly in patients who frequently have associated comorbidities that limit the use of conventional therapies. The main mechanism of crystal-induced inflammation is interleukin-1 production by activation of the inflammasome. We aimed to evaluate the efficacy and tolerance of anakinra in gouty patients. METHODS: We conducted a multicenter retrospective review of patients receiving anakinra for gouty arthritis. We reviewed the response to treatment, adverse events and relapses. RESULTS: We examined data for 40 gouty patients (32 men; mean age 60.0 ± 13.9 years) receiving anakinra. Mean disease duration was 8.7 ± 8.7 years. All patients showed contraindications to and/or failure of at least two conventional therapies. Most (36; 90%) demonstrated good response to anakinra. Median pain on a 100-mm visual analog scale was rapidly decreased (73.5 (70.0 to 80.0) to 25.0 (20.0 to 32.5) mm, P < 0.0001), as was median C-reactive protein (CRP) level (130.5 (55.8 to 238.8) to 16.0 (5.0 to 29.5) mg/l, P < 0.0001). After a median follow-up of 7.0 (2.0 to 13.0) months, relapse occurred in 13 patients after a median delay of 15.0 (10.0 to 70.0) days. Seven infectious events, mainly with long-term use of anakinra, were noted. CONCLUSIONS: Anakinra may be efficient in gouty arthritis, is relatively well tolerated with short-term use, and could be a relevant option in managing gouty arthritis when conventional therapies are ineffective or contraindicated. Its long-term use could be limited by infectious complications.

21 Article A delphi exercise to identify characteristic features of gout - opinions from patients and physicians, the first stage in developing new classification criteria. 2013

Prowse, Rebecca L / Dalbeth, Nicola / Kavanaugh, Arthur / Adebajo, Adewale O / Gaffo, Angelo L / Terkeltaub, Robert / Mandell, Brian F / Suryana, Bagus P P / Goldenstein-Schainberg, Claudia / Diaz-Torne, Cèsar / Khanna, Dinesh / Lioté, Frederic / Mccarthy, Geraldine / Kerr, Gail S / Yamanaka, Hisashi / Janssens, Hein / Baraf, Herbert F / Chen, Jiunn-Horng / Vazquez-Mellado, Janitzia / Harrold, Leslie R / Stamp, Lisa K / Van De Laar, Mart A / Janssen, Matthijs / Doherty, Michael / Boers, Maarten / Edwards, N Lawrence / Gow, Peter / Chapman, Peter / Khanna, Puja / Helliwell, Philip S / Grainger, Rebecca / Schumacher, H Ralph / Neogi, Tuhina / Jansen, Tim L / Louthrenoo, Worawit / Sivera, Francisca / Taylor, William J / Alten, Rieke. ·University of Otago, Dunedin, New Zealand. ·J Rheumatol · Pubmed #23418379.

ABSTRACT: OBJECTIVE: To identify a comprehensive list of features that might discriminate between gout and other rheumatic musculoskeletal conditions, to be used subsequently for a case-control study to develop and test new classification criteria for gout. METHODS: Two Delphi exercises were conducted using Web-based questionnaires: one with physicians from several countries who had an interest in gout and one with patients from New Zealand who had gout. Physicians rated a list of potentially discriminating features that were identified by literature review and expert opinion, and patients rated a list of features that they generated themselves. Agreement was defined by the RAND/UCLA disagreement index. RESULTS: Forty-four experienced physicians and 9 patients responded to all iterations. For physicians, 71 items were identified by literature review and 15 more were suggested by physicians. The physician survey showed agreement for 26 discriminatory features and 15 as not discriminatory. The patients identified 46 features of gout, for which there was agreement on 25 items as being discriminatory and 7 items as not discriminatory. CONCLUSION: Patients and physicians agreed upon several key features of gout. Physicians emphasized objective findings, imaging, and patterns of symptoms, whereas patients emphasized severity, functional results, and idiographic perception of symptoms.

22 Article GOSPEL: prospective survey of gout in France. Part I: design and patient characteristics (n = 1003). 2012

Lioté, Frédéric / Lancrenon, Sylvie / Lanz, Sabine / Guggenbuhl, Pascal / Lambert, Charles / Saraux, Alain / Chiarelli, Pierre / Delva, Catherine / Aubert, Jean-Pierre / Ea, Hang-Korng. ·Université Paris-Diderot, Sorbonne Paris-Cité, 75205 Paris, France. frederic.liote@lrb.aphp.fr ·Joint Bone Spine · Pubmed #22281230.

ABSTRACT: OBJECTIVES: To assess diagnoses and management of acute and chronic gout in primary care and rheumatology settings relative to 2006 European League Against Rheumatism (EULAR) gout recommendations. Secondary objectives were to describe patient demographics, clinical features, lifestyle modifications, and short- and mid-term outcomes. METHODS: Prospective, cross-sectional, descriptive survey of patients with chronic gout, acute gout, or suspected gout, included by randomly selected general practitioners (GPs, n = 398) and rheumatologists (n = 109) between October 2008 and September 2009, in France. At the first visit, a structured questionnaire was completed. Each patient completed self-questionnaires at the first visit and 3 to 6 months later. RESULTS: We included 1003 patients, including 879 (87.6%) males (mean age, 61.6 ± 11.4 years; 28.1% obese) and 124 (12.4%) females (70.2 ± 11.9 years; 33.1% obese). Mean disease duration was 8.0 ± 8.3 years and mean time since hyperuricemia diagnosis 8.2 ± 8.4 years. Mean annual number of flares was 1.9 ± 1.5. ACR criteria for gout were met in 855 pts. Gout was acute in 487 (48.6%) patients and chronic in 241 (24.4%). Tophi (19.4% of patients) were associated with disease duration but not gender or chronic kidney disease (CKD). The main co-morbidities were hypertension (53.8%), dyslipidemia (47.2%), and hyperglycemia/diabetes mellitus (15.0%). CKD 3-5 was present in 43% of patients but was identified by physicians in only 5.2%. CKD severity was significantly associated with age, gender, hypertension, and diuretic use. CONCLUSION: This cohort will prove valuable for addressing the concordance with EULAR recommendations and for future studies of gout in everyday practice, most notably regarding metabolic syndrome, other co-morbidities, and identification of difficult-to-treat patients.

23 Article Severe gouty arthritis and mild neurologic symptoms due to F199C, a newly identified variant of the hypoxanthine guanine phosphoribosyltransferase. 2009

Ea, Hang-Korng / Bardin, Thomas / Jinnah, H A / Aral, Bernard / Lioté, Frédéric / Ceballos-Picot, Irène. ·Hôpital Lariboisière, INSERM UMR-S 606, Paris, France. ·Arthritis Rheum · Pubmed #19565499.

ABSTRACT: A deficiency in hypoxanthine guanine phosphoribosyltransferase (HPRT) activity leads to overproduction of uric acid. According to the degree of enzymatic deficiency, a large spectrum of neurologic features can also be observed, ranging from mild or no neurologic involvement to complete Lesch-Nyhan disease. Herein, we describe a patient with hyperuricemia, juvenile-onset gouty arthritis, nephrolithiasis, and mild neurologic symptoms, attributed to a newly identified variant of the hprt gene, c.596T>G, resulting in the amino acid change p.F199C. Residual HPRT activity (8%) protected against severe neurologic involvement in this patient. Modeling of the mutated protein was used to predict the mechanisms that led to partial enzymatic activity. Careful neurologic examination is warranted in juvenile and middle-aged patients with gout, in order to detect mild symptoms that may lead to a diagnosis of HPRT deficiency.

24 Article Gout Study Group: update on hyperuricemia and gout. 2009

Terkeltaub, Robert / Zelman, David / Scavulli, John / Perez-Ruiz, Fernando / Lioté, Frédéric. ·Veterans Affairs Medical Center, University of California San Diego, 111K, 3350 La Jolla Village Drive, San Diego, CA 92161, USA. rterkeltaub@ucsd.edu ·Joint Bone Spine · Pubmed #19559637.

ABSTRACT: -- No abstract --

25 Unspecified Workshop report: 4th European crystal network meeting. 2013

Lioté, Frédéric / Merriman, Tony / Nasi, Sonia / So, Alexander. · ·Arthritis Res Ther · Pubmed #24165477.

ABSTRACT: -- No abstract --

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