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Gout: HELP
Articles by Geraldine M. McCarthy
Based on 13 articles published since 2008
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Between 2008 and 2019, G. McCarthy wrote the following 13 articles about Gout.
 
+ Citations + Abstracts
1 Review Colchicine: New Insights to an Old Drug. 2015

Stack, John / Ryan, John / McCarthy, Geraldine. ·1Department of Rheumatology, Cork University Hospital, Cork, Ireland; and 2Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland. ·Am J Ther · Pubmed #24100258.

ABSTRACT: Colchicine is an ancient drug that is used for symptomatic relief in a wide range of inflammatory diseases including gout, Behçet syndrome, and familial Mediterranean fever. Recognition of its antiinflammatory properties and of its unpleasant gastrointestinal side effects date back thousands of years. Despite this, uncertainty remains concerning its mechanism of action and very few randomized controlled trials have been carried out to examine its safety and efficacy to date. Although it is an effective drug, its use is hindered by a very narrow therapeutic index. This review attempts to summarize recent developments concerning the use of colchicine in the treatment of gout with particular focus on its mechanism of action and toxicity.

2 Clinical Trial Increased platelet reactivity as measured by plasma glycoprotein VI in gout. 2018

Conway, Richard / Murphy, Claire-Louise / Madigan, Anne / Kavanagh, Patricia / Geraghty, Liz / Redmond, Niamh / Helbert, Laura / Carey, John J / Dunne, Eimear / Kenny, Dermot / McCarthy, Geraldine M. ·a Department of Rheumatology , Mater Misericordiae University Hospital, Dublin Academic Medical Centre , Dublin , Ireland. · b CARD Newman Research Fellow, University College Dublin , Dublin , Ireland. · c Centre for Rheumatology Research , University College London Division of Medicine , London , United Kingdom. · d Clinical Research Centre, Mater Misericordiae University Hospital, Dublin Academic Medical Centre , Dublin , Ireland. · e Department of Rheumatology , Galway University Hospitals , Galway , Ireland. · f Cardiovascular Biology and Clinical Research Centre, Royal College of Surgeons in Ireland , Dublin , Ireland. ·Platelets · Pubmed #29090618.

ABSTRACT: Patients with gout have an increased risk of cardiovascular events. The glycoprotein VI (GPVI) receptor is found exclusively on platelets and megakaryocytes, is proteolytically cleaved upon platelet activation, and detectable in plasma as soluble GPVI (sGPVI). Therefore, elevated sGPVI is a marker of platelet activation and a risk marker for cardiovascular events. The aim of this study was to assess platelet activation, as measured by plasma sGPVI level in gout. Blood samples were taken from patients with gout or osteoarthritis, and from healthy volunteers. Demographic and clinical data were collected for all participants. Blood samples were processed as double-spun platelet-poor plasma. Plasma sGPVI levels were measured using enzyme-linked immunosorbent assay. Mann-Whitney U test was used to compare groups. In total, 91 patients were included, 27 during gout flare, 41 with intercritical gout, 23 with osteoarthritis, and 53 healthy controls. Median (interquartile range) sGPVI levels were 6.51 ng/mL (4.52, 8.41) in gout flare, 3.58 ng/mL (2.11, 5.55) in intercritical gout, 2.73 ng/mL (2.17, 3.72) in osteoarthritis, and 2.19 ng/mL (1.72, 3.31) in healthy controls. Plasma sGPVI levels in both gout groups were significantly increased compared to healthy controls (p < 0.005 for each), in gout flare compared to osteoarthritis (p < 0.005), and in gout flare compared to intercritical gout (p = 0.001). There was no significant difference in sGPVI levels in gout patients with and without tophi or in those prescribed colchicine. We conclude that patients with gout exhibit platelet hyperactivity as demonstrated by elevated sGPVI levels. Platelet activation is exacerbated in gout, especially during gout flares.

3 Article Brief Report: Validation of a Definition of Flare in Patients With Established Gout. 2018

Gaffo, Angelo L / Dalbeth, Nicola / Saag, Kenneth G / Singh, Jasvinder A / Rahn, Elizabeth J / Mudano, Amy S / Chen, Yi-Hsing / Lin, Ching-Tsai / Bourke, Sandra / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Hernández-Llinas, Hansel / Neogi, Tuhina / Vargas-Santos, Ana Beatriz / da Rocha Castelar-Pinheiro, Geraldo / Amorim, Rodrigo B C / Uhlig, Till / Hammer, Hilde B / Eliseev, Maxim / Perez-Ruiz, Fernando / Cavagna, Lorenzo / McCarthy, Geraldine M / Stamp, Lisa K / Gerritsen, Martijn / Fana, Viktoria / Sivera, Francisca / Taylor, William. ·University of Alabama at Birmingham and Birmingham VA Medical Center, Birmingham, Alabama. · University of Auckland, Auckland, New Zealand. · University of Alabama at Birmingham. · Taichung Veterans General Hospital, Taichung, Taiwan. · Chiang Mai University, Chiang Mai, Thailand. · Hospital General de Mexico, Mexico City, Mexico. · Boston University School of Medicine, Boston, Massachusetts. · Boston University School of Medicine, Boston, Massachusetts, and Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Diakonhjemmet Hospital, Oslo, Norway. · Research Institute of Rheumatology of Russia, Moscow, Russia. · University of the Basque Country, Cruces University Hospital, and Biocruces Health Research Institute, Vizcaya, Spain. · University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. · Mater Misericordiae University Hospital, Dublin, Ireland. · University of Otago, Christchurch, New Zealand. · Westfries Gasthuis, Hoorn, The Netherlands. · Rigshospitalet Glostrup, Copenhagen, Denmark. · Hospital General Universitario Elda, Elda, Spain. · University of Wellington, Wellington, New Zealand. ·Arthritis Rheumatol · Pubmed #29161469.

ABSTRACT: OBJECTIVE: To perform external validation of a provisional definition of disease flare in patients with gout. METHODS: Five hundred nine patients with gout were enrolled in a cross-sectional study during a routine clinical care visit at 17 international sites. Data were collected to classify patients as experiencing or not experiencing a gout flare, according to a provisional definition. A local expert rheumatologist performed the final independent adjudication of gout flare status. Sensitivity, specificity, predictive values, and receiver operating characteristic (ROC) curves were used to determine the diagnostic performance of gout flare definitions. RESULTS: The mean ± SD age of the patients was 57.5 ± 13.9 years, and 89% were male. The definition requiring fulfillment of at least 3 of 4 criteria (patient-defined gout flare, pain at rest score of >3 on a 0-10-point numerical rating scale, presence of at least 1 swollen joint, and presence of at least 1 warm joint) was 85% sensitive and 95% specific in confirming the presence of a gout flare, with an accuracy of 92%. The ROC area under the curve was 0.97. The definition based on a classification and regression tree algorithm (entry point, pain at rest score >3, followed by patient-defined flare "yes") was 73% sensitive and 96% specific. CONCLUSION: The definition of gout flare that requires fulfillment of at least 3 of 4 patient-reported criteria is now validated to be sensitive, specific, and accurate for gout flares, as demonstrated using an independent large international patient sample. The availability of a validated gout flare definition will improve the ascertainment of an important clinical outcome in studies of gout.

4 Article Performance of Ultrasound in the Diagnosis of Gout in a Multicenter Study: Comparison With Monosodium Urate Monohydrate Crystal Analysis as the Gold Standard. 2017

Ogdie, Alexis / Taylor, William J / Neogi, Tuhina / Fransen, Jaap / Jansen, Tim L / Schumacher, H Ralph / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Eliseev, Maxim / McCarthy, Geraldine / Stamp, Lisa K / Perez-Ruiz, Fernando / Sivera, Francisca / Ea, Hang-Korng / Gerritsen, Martijn / Cagnotto, Giovanni / Cavagna, Lorenzo / Lin, Chingtsai / Chou, Yin-Yi / Tausche, Anne-Kathrin / Lima Gomes Ochtrop, Manuella / Janssen, Matthijs / Chen, Jiunn-Horng / Slot, Ole / Lazovskis, Juris / White, Douglas / Cimmino, Marco A / Uhlig, Till / Dalbeth, Nicola. ·University of Pennsylvania, Philadelphia. · University of Otago, Wellington, New Zealand. · Boston University School of Medicine, Boston, Massachusetts. · VieCuri Medical Centre, Venlo, The Netherlands, and Scientific IQ HealthCare, Radboud University Medical Center, Nijmegen, The Netherlands. · Chiang Mai University, Chiang Mai, Thailand. · Hospital General de México, Mexico City, Mexico. · Nasonova Research Institute of Rheumatology of Russia, Moscow, Russia. · University College Dublin and Mater Misericordiae University Hospital, Dublin, Ireland. · University of Otago Christchurch, Christchurch, New Zealand. · Hospital Universitario Cruces, BioCruces Health Research Institute, and Basque Country University, Barakaldo, Spain. · Hospital General Universitario de Elda, Alicante, Spain. · Université Paris Diderot, INSERM UMR 1132 and Service de Rhumatologie, Hôpital Lariboisière, AP-HP, Paris, France. · Westfries Gasthuis, Hoorn, The Netherlands. · University of Pavia and IRCCS Policlinico San Matteo Foundation, Pavia, Italy, and Skane University Hospital Malmö/Lund, Lund, Sweden. · University of Pavia and IRCCS Policlinico San Matteo Foundation, Pavia, Italy. · Taichung Veterans' General Hospital, Taichung, Taiwan, Republic of China. · University Hospital Carl Gustav Carus, Dresden, Germany. · Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Rijnstate Hospital, Arnhem, The Netherlands. · China Medical University Hospital, Taichung, Taiwan, Republic of China. · Copenhagen University Hospital Glostrup, Glostrup, Denmark. · Riverside Professional Centre, Sydney, Nova Scotia, Canada. · Waikato District Health Board and Waikato Clinical School, Hamilton, New Zealand. · University of Genoa, Genoa, Italy. · Diakonhjemmet Hospital, Oslo, Norway. · University of Auckland, Auckland, New Zealand. ·Arthritis Rheumatol · Pubmed #27748084.

ABSTRACT: OBJECTIVE: To examine the performance of ultrasound (US) for the diagnosis of gout using the presence of monosodium urate monohydrate (MSU) crystals as the gold standard. METHODS: We analyzed data from the Study for Updated Gout Classification Criteria (SUGAR), a large, multicenter observational cross-sectional study of consecutive subjects with at least 1 swollen joint who conceivably may have gout. All subjects underwent arthrocentesis; cases were subjects with confirmed MSU crystals. Rheumatologists or radiologists who were blinded with regard to the results of the MSU crystal analysis performed US on 1 or more clinically affected joints. US findings of interest were double contour sign, tophus, and snowstorm appearance. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Multivariable logistic regression models were used to examine factors associated with positive US results among subjects with gout. RESULTS: US was performed in 824 subjects (416 cases and 408 controls). The sensitivity, specificity, PPV, and NPV for the presence of any 1 of the features were 76.9%, 84.3%, 83.3%, and 78.2%, respectively. Sensitivity was higher among subjects with a disease duration of ≥2 years and among subjects with subcutaneous nodules on examination (suspected tophus). Associations with a positive US finding included suspected clinical tophus (odds ratio [OR] 4.77 [95% confidence interval (95% CI) 2.23-10.21]), any abnormality on plain radiography (OR 4.68 [95% CI 2.68-8.17]), and serum urate level (OR 1.31 [95% CI 1.06-1.62]). CONCLUSION: US features of MSU crystal deposition had high specificity and high PPV but more limited sensitivity for early gout. The specificity remained high in subjects with early disease and without clinical signs of tophi.

5 Article Survey Definitions of Gout for Epidemiologic Studies: Comparison With Crystal Identification as the Gold Standard. 2016

Dalbeth, Nicola / Schumacher, H Ralph / Fransen, Jaap / Neogi, Tuhina / Jansen, Tim L / Brown, Melanie / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Eliseev, Maxim / McCarthy, Geraldine / Stamp, Lisa K / Perez-Ruiz, Fernando / Sivera, Francisca / Ea, Hang-Korng / Gerritsen, Martijn / Scire, Carlo A / Cavagna, Lorenzo / Lin, Chingtsai / Chou, Yin-Yi / Tausche, Anne-Kathrin / da Rocha Castelar-Pinheiro, Geraldo / Janssen, Matthijs / Chen, Jiunn-Horng / Cimmino, Marco A / Uhlig, Till / Taylor, William J. ·University of Auckland, Auckland, New Zealand. · University of Pennsylvania, Philadelphia. · Radboud University Medical Centre, Nijmegen, The Netherlands. · Boston University School of Medicine, Boston, Massachusetts. · Viecuri Medical Center, Venlo, The Netherlands. · University of Otago, Wellington, New Zealand. · Chiang Mai University, Chiang Mai, Thailand. · Hospital General de Mexico, Mexico City, Mexico. · Nasonova Research Institute of Rheumatology of Russia, Moscow, Russia. · Geraldine McCarthy, MD, FRCPI, University College Dublin School of Medicine and Medical Science, Dublin, Ireland. · University of Otago, Christchurch, New Zealand. · Hospital Universitario Cruces & BioCruces Health Research Institute, Vizcaya, Spain. · Hospital General Universitario de Elda, Alicante, Spain. · Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, INSERM, UMR 1132, Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, and Hôpital Lariboisière, Paris, France. · Westfries Gasthuis, Hoorn, The Netherlands. · Carlo A. Scire, MD, PhD, Italian Society for Rheumatology, Milan, Italy. · University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. · Taichung Veterans General Hospital, Taichung, Taiwan. · University Hospital Carl Gustav Carus, Dresden, Germany. · Universidade de Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Rijnstate Hospital, Arnhem, The Netherlands. · China Medical University School of Medicine, Taichung, Taiwan. · University of Genoa, Genoa, Italy. · Diakonhjemmet Hospital, Oslo, Norway. ·Arthritis Care Res (Hoboken) · Pubmed #27014846.

ABSTRACT: OBJECTIVE: To identify the best-performing survey definition of gout from items commonly available in epidemiologic studies. METHODS: Survey definitions of gout were identified from 34 epidemiologic studies contributing to the Global Urate Genetics Consortium (GUGC) genome-wide association study. Data from the Study for Updated Gout Classification Criteria (SUGAR) were randomly divided into development and test data sets. A data-driven case definition was formed using logistic regression in the development data set. This definition, along with definitions used in GUGC studies and the 2015 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) gout classification criteria were applied to the test data set, using monosodium urate crystal identification as the gold standard. RESULTS: For all tested GUGC definitions, the simple definition of "self-report of gout or urate-lowering therapy use" had the best test performance characteristics (sensitivity 82%, specificity 72%). The simple definition had similar performance to a SUGAR data-driven case definition with 5 weighted items: self-report, self-report of doctor diagnosis, colchicine use, urate-lowering therapy use, and hyperuricemia (sensitivity 87%, specificity 70%). Both of these definitions performed better than the 1977 American Rheumatism Association survey criteria (sensitivity 82%, specificity 67%). Of all tested definitions, the 2015 ACR/EULAR criteria had the best performance (sensitivity 92%, specificity 89%). CONCLUSION: A simple definition of "self-report of gout or urate-lowering therapy use" has the best test performance characteristics of existing definitions that use routinely available data. A more complex combination of features is more sensitive, but still lacks good specificity. If a more accurate case definition is required for a particular study, the 2015 ACR/EULAR gout classification criteria should be considered.

6 Article Diagnostic Arthrocentesis for Suspicion of Gout Is Safe and Well Tolerated. 2016

Taylor, William J / Fransen, Jaap / Dalbeth, Nicola / Neogi, Tuhina / Ralph Schumacher, H / Brown, Melanie / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Eliseev, Maxim / McCarthy, Geraldine / Stamp, Lisa K / Perez-Ruiz, Fernando / Sivera, Francisca / Ea, Hang-Korng / Gerritsen, Martijn / Scire, Carlo A / Cavagna, Lorenzo / Lin, Chingtsai / Chou, Yin-Yi / Tausche, Anne-Kathrin / da Rocha Castelar-Pinheiro, Geraldo / Janssen, Matthijs / Chen, Jiunn-Horng / Slot, Ole / Cimmino, Marco / Uhlig, Till / Jansen, Tim L. ·From the University of Otago, Wellington; University of Auckland, Auckland; Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand; Radboud University Medical Centre, Nijmegen; Amsterdam Rheumatology Immunology Center (ARC), Department of Rheumatology, Westfries Gasthuis, Hoorn; Rijnstate Hospital, Arnhem, the Netherlands; Boston University School of Medicine, Boston, Massachusetts; University of Pennsylvania, Philadelphia, Pennsylvania, USA; Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; Servicio de Reumatología, Hospital General de México, México City, México; Nasonova Research Institute of Rheumatology of Russia, Moscow, Russia; School of Medicine and Medical Science, University College Dublin; Mater Misericordiae University Hospital, Dublin, Ireland; Rheumatology Division, Hospital Universitario Cruces and BioCruces Health Research Institute, Vizcaya; Department Reumatologia, Hospital General Universitario de Elda, Alicante, Spain; Université Paris Diderot, Sorbonne Paris Cité, UFR de Médecine; Institut national de la santé et de la recherche médicale (INSERM), UMR 1132, Hôpital Lariboisière; Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière, Service de Rhumatologie, Centre Viggo Petersen, Pôle Appareil Locomoteur, Paris, France; Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan; Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia; Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, Genoa, Italy; Division of Rheumatology and Immunology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation; Taichung Veterans' General Hospital; School of Medicine, China Medical University; Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan; Division of Rheumatology, Department of In ·J Rheumatol · Pubmed #26628602.

ABSTRACT: OBJECTIVE: To determine the frequency of adverse events of diagnostic arthrocentesis in patients with possible gout. METHODS: Consecutive patients underwent arthrocentesis and were evaluated at 6 weeks to determine adverse events. The 95% CI were obtained by bootstrapping. RESULTS: Arthrocentesis was performed in 910 patients, and 887 (97.5%) were evaluated for adverse events. Any adverse event was observed in 12 participants (1.4%, 95% CI 0.6-2.1). There was 1 case (0.1%, 95% CI 0-0.34) of septic arthritis. CONCLUSIONS: Diagnostic arthrocentesis is associated with a low frequency of adverse events. Septic arthritis rarely occurs.

7 Article Development of Preliminary Remission Criteria for Gout Using Delphi and 1000Minds Consensus Exercises. 2016

de Lautour, Hugh / Taylor, William J / Adebajo, Ade / Alten, Rieke / Burgos-Vargas, Ruben / Chapman, Peter / Cimmino, Marco A / da Rocha Castelar Pinheiro, Geraldo / Day, Ric / Harrold, Leslie R / Helliwell, Philip / Janssen, Matthijs / Kerr, Gail / Kavanaugh, Arthur / Khanna, Dinesh / Khanna, Puja P / Lin, Chingtsai / Louthrenoo, Worawit / McCarthy, Geraldine / Vazquez-Mellado, Janitzia / Mikuls, Ted R / Neogi, Tuhina / Ogdie, Alexis / Perez-Ruiz, Fernando / Schlesinger, Naomi / Ralph Schumacher, H / Scirè, Carlo A / Singh, Jasvinder A / Sivera, Francisca / Slot, Ole / Stamp, Lisa K / Tausche, Anne-Kathrin / Terkeltaub, Robert / Uhlig, Till / van de Laar, Mart / White, Douglas / Yamanaka, Hisashi / Zeng, Xuejun / Dalbeth, Nicola. ·Auckland District Health Board, Auckland, New Zealand. · University of Otago, Wellington, New Zealand. · University of Sheffield, Sheffield, UK. · Schlosspark-Klinik, Charité, University Medicine Berlin, Berlin, Germany. · Hospital General de México, Mexico City, Mexico. · Christchurch Hospital, Christchurch, New Zealand. · Università di Genova, Genova, Italy. · Pedro Ernesto University Hospital, Rio de Janeiro, Brazil. · University of New South Wales and St Vincent's Hospital, Sydney, Australia. · University of Massachusetts Medical School, Worcester, and Corrona, LLC, Southborough. · Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK. · Rijnstate Hospital, Arnhem, The Netherlands. · Veterans Affairs Medical Center, Georgetown and Howard University Hospitals, Washington, DC. · University of California School of Medicine, San Diego. · University of Michigan, Ann Arbor. · University of Michigan and Ann Arbor VA Medical Center, Ann Arbor. · Taichung Veteran's General Hospital, Taichung, Taiwan. · Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Mater Misericordiae University Hospital and University College, Dublin, Ireland. · Nebraska-Western Iowa Health Care System and University of Nebraska Medical Center, Omaha. · Boston University School of Medicine, Boston, Massachusetts. · University of Pennsylvania, Philadelphia. · Hospital Universitario Cruces, OSI-EEC, and Biocruces Health Research Institute, Biscay, Spain. · Rutgers University Robert Wood Johnson Medical School, New Brunswick, New Jersey. · IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy. · University of Alabama at Birmingham and the Birmingham VA Medical Center, Birmingham. · Hospital General Universitario Elda, Elda, Spain. · Copenhagen University Hospital Glostrup, Glostrup, Denmark. · University of Otago, Christchurch, New Zealand. · University Hospital Carl Gustav Carus, Dresden, Germany. · University of California San Diego VA Medical Center, La Jolla. · National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway. · Universiteit Twente, Erschede, The Netherlands. · Waikato DHB and Waikato Clinical School, University of Auckland, Hamilton, New Zealand. · Tokyo Women's Medical University, Tokyo, Japan. · Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College, Beijing, China. · University of Auckland and Auckland District Health Board, Auckland, New Zealand. ·Arthritis Care Res (Hoboken) · Pubmed #26414176.

ABSTRACT: OBJECTIVE: To establish consensus for potential remission criteria to use in clinical trials of gout. METHODS: Experts (n = 88) in gout from multiple countries were invited to participate in a web-based questionnaire study. Three rounds of Delphi consensus exercises were conducted using SurveyMonkey, followed by a discrete-choice experiment using 1000Minds software. The exercises focused on identifying domains, definitions for each domain, and the timeframe over which remission should be defined. RESULTS: There were 49 respondents (56% response) to the initial survey, with subsequent response rates ranging from 57% to 90%. Consensus was reached for the inclusion of serum urate (98% agreement), flares (96%), tophi (92%), pain (83%), and patient global assessment of disease activity (93%) as measurement domains in remission criteria. Consensus was also reached for domain definitions, including serum urate (<0.36 mm), pain (<2 on a 10-point scale), and patient global assessment (<2 on a 10-point scale), all of which should be measured at least twice over a set time interval. Consensus was not achieved in the Delphi exercise for the timeframe for remission, with equal responses for 6 months (51%) and 1 year (49%). In the discrete-choice experiment, there was a preference towards 12 months as a timeframe for remission. CONCLUSION: These consensus exercises have identified domains and provisional definitions for gout remission criteria. Based on the results of these exercises, preliminary remission criteria are proposed with domains of serum urate, acute flares, tophus, pain, and patient global assessment. These preliminary criteria now require testing in clinical data sets.

8 Article Performance of classification criteria for gout in early and established disease. 2016

Taylor, William J / Fransen, Jaap / Dalbeth, Nicola / Neogi, Tuhina / Schumacher, H Ralph / Brown, Melanie / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Eliseev, Maxim / McCarthy, Geraldine / Stamp, Lisa K / Perez-Ruiz, Fernando / Sivera, Francisca / Ea, Hang-Korng / Gerritsen, Martijn / Scire, Carlo / Cavagna, Lorenzo / Lin, Chingtsai / Chou, Yin-Yi / Tausche, Anne-Kathrin / da Rocha Castelar-Pinheiro, Geraldo / Janssen, Matthijs / Chen, Jiunn-Horng / Slot, Ole / Cimmino, Marco / Uhlig, Till / Jansen, Tim L. ·Department of Medicine, University of Otago, Wellington, New Zealand. · Department of Rheumatology, Radboud University Medical Centre, Nijmegen, Netherlands. · Department of Medicine, University of Auckland, Auckland, New Zealand. · Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, Boston, Massachusetts, USA. · VA Medical Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. · Servicio de Reumatología, Hospital General de México, México City, México. · Nasonova Research Institute of Rheumatology of Russia, Moscow, Russia. · School of Medicine and Medical Science, University College Dublin, Dublin, Ireland Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland. · Department of Medicine, University of Otago, Christchurch, Canterbury, New Zealand. · Rheumatology Division, Hospital Universitario Cruces & BioCruces Health Research Institute, Vizcaya, Spain. · Department Reumatologia, Hospital General Universitario de Elda, Alicante, Spain. · University of Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, Paris, France INSERM, UMR 1132, Hôpital Lariboisière, Paris, France Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Lariboisière, Service de Rhumatologie, Centre Viggo Petersen, Pôle Appareil Locomoteur, 2, Rue Ambroise Paré, Paris, France. · Department of Rheumatology, Amsterdam Rheumatology Immunology Center (ARC), Westfries Gasthuis, Hoorn, the Netherlands. · Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy. · Division of Rheumatology, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. · Division of Rheumatology and Immunology, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan, ROC. · Taichung Veterans' General Hospital, Taichung, Taiwan, ROC. · Division of Rheumatology, Department of Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany. · Division of Rheumatology, Department of Internal Medicine, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil. · Department of Rheumatology, Rijnstate Hospital, Arnhem, the Netherlands. · School of Medicine, China Medical University, Taichung, Taiwan, ROC Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan, ROC. · Centre of Rheumatology and Spine Disorders, Copenhagen University Hospital Glostrup, Glostrup, Denmark. · Research Laboratory and Academic Division of Clinical Rheumatology, Department of Internal Medicine, University of Genova, Genova, Italy. · National Advisory Unit on Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Vinderen, Oslo, Norway. ·Ann Rheum Dis · Pubmed #25351521.

ABSTRACT: OBJECTIVES: To compare the sensitivity and specificity of different classification criteria for gout in early and established disease. METHODS: This was a cross-sectional study of consecutive rheumatology clinic patients with joint swelling in which gout was defined by presence or absence of monosodium urate crystals as observed by a certified examiner at presentation. Early disease was defined as patient-reported onset of symptoms of 2 years or less. RESULTS: Data from 983 patients were collected and gout was present in 509 (52%). Early disease was present in 144 gout cases and 228 non-cases. Sensitivity across criteria was better in established disease (95.3% vs 84.1%, p<0.001) and specificity was better in early disease (79.9% vs 52.5%, p<0.001). The overall best performing clinical criteria were the Rome criteria with sensitivity/specificity in early and established disease of 60.3%/84.4% and 86.4%/63.6%. Criteria not requiring synovial fluid analysis had sensitivity and specificity of less than 80% in early and established disease. CONCLUSIONS: Existing classification criteria for gout have sensitivity of over 80% in early and established disease but currently available criteria that do not require synovial fluid analysis have inadequate specificity especially later in the disease. Classification criteria for gout with better specificity are required, although the findings should be cautiously applied to non-rheumatology clinic populations.

9 Article Study for Updated Gout Classification Criteria: Identification of Features to Classify Gout. 2015

Taylor, William J / Fransen, Jaap / Jansen, Tim L / Dalbeth, Nicola / Schumacher, H Ralph / Brown, Melanie / Louthrenoo, Worawit / Vazquez-Mellado, Janitzia / Eliseev, Maxim / McCarthy, Geraldine / Stamp, Lisa K / Perez-Ruiz, Fernando / Sivera, Francisca / Ea, Hang-Korng / Gerritsen, Martijn / Scire, Carlo / Cavagna, Lorenzo / Lin, Chingtsai / Chou, Yin-Yi / Tausche, Anne Kathrin / Vargas-Santos, Ana Beatriz / Janssen, Matthijs / Chen, Jiunn-Horng / Slot, Ole / Cimmino, Marco A / Uhlig, Till / Neogi, Tuhina. ·University of Otago, Wellington, New Zealand. · Radboud University Medical Centre, Nijmegen, The Netherlands. · University of Auckland, Auckland, New Zealand. · University of Pennsylvania and VA Medical Center, Philadelphia. · Chiang Mai University, Chiang Mai, Thailand. · Hospital General de México, Mexico City, Mexico. · Nasonova Research Institute of Rheumatology, Moscow, Russia. · University College, Mater Misericordiae University Hospital, Dublin, Ireland. · University of Otago Christchurch, Christchurch, New Zealand. · Hospital Universitario Cruces and BioCruces Health Research Institute, Vizcaya, Spain. · Hospital General Universitario de Elda, Alicante, Spain. · University of Paris Diderot, Sorbonne Paris Cité, UFR de Médecine, INSERM, UMR 1132, Hôpital Lariboisière, AP-HP, Paris, France. · Amsterdam Rheumatology Immunology Center, Westfries Gasthuis, Hoorn, The Netherlands. · Italian Society for Rheumatology, Milan, Italy. · University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy. · Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taiwan. · Taichung Veterans' General Hospital, Taichung, Taiwan. · University Hospital Carl Gustav Carus, Dresden, Germany. · Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. · Rijnstate Hospital, Arnhem, The Netherlands. · China Medical University and China Medical University Hospital, Taichung, Taiwan. · Copenhagen University Hospital, Glostrup, Denmark. · University of Genoa, Genoa, Italy. · Diakonhjemmet Hospital, Oslo, Norway. · Boston University School of Medicine, Boston, Massachusetts. ·Arthritis Care Res (Hoboken) · Pubmed #25777045.

ABSTRACT: OBJECTIVE: To determine which clinical, laboratory, and imaging features most accurately distinguished gout from non-gout. METHODS: We performed a cross-sectional study of consecutive rheumatology clinic patients with ≥1 swollen joint or subcutaneous tophus. Gout was defined by synovial fluid or tophus aspirate microscopy by certified examiners in all patients. The sample was randomly divided into a model development (two-thirds) and test sample (one-third). Univariate and multivariate association between clinical features and monosodium urate-defined gout was determined using logistic regression modeling. Shrinkage of regression weights was performed to prevent overfitting of the final model. Latent class analysis was conducted to identify patterns of joint involvement. RESULTS: In total, 983 patients were included. Gout was present in 509 (52%). In the development sample (n = 653), the following features were selected for the final model: joint erythema (multivariate odds ratio [OR] 2.13), difficulty walking (multivariate OR 7.34), time to maximal pain <24 hours (multivariate OR 1.32), resolution by 2 weeks (multivariate OR 3.58), tophus (multivariate OR 7.29), first metatarsophalangeal (MTP1) joint ever involved (multivariate OR 2.30), location of currently tender joints in other foot/ankle (multivariate OR 2.28) or MTP1 joint (multivariate OR 2.82), serum urate level >6 mg/dl (0.36 mmoles/liter; multivariate OR 3.35), ultrasound double contour sign (multivariate OR 7.23), and radiograph erosion or cyst (multivariate OR 2.49). The final model performed adequately in the test set, with no evidence of misfit, high discrimination, and predictive ability. MTP1 joint involvement was the most common joint pattern (39.4%) in gout cases. CONCLUSION: Ten key discriminating features have been identified for further evaluation for new gout classification criteria. Ultrasound findings and degree of uricemia add discriminating value, and will significantly contribute to more accurate classification criteria.

10 Article Interactions between tenocytes and monosodium urate monohydrate crystals: implications for tendon involvement in gout. 2014

Chhana, Ashika / Callon, Karen E / Dray, Michael / Pool, Bregina / Naot, Dorit / Gamble, Greg D / Coleman, Brendan / McCarthy, Geraldine / McQueen, Fiona M / Cornish, Jillian / Dalbeth, Nicola. ·Bone & Joint Research Group, Department of Medicine, University of Auckland, Auckland, New Zealand. · Department of Histology, Waikato Hospital, Hamilton, New Zealand. · Department of Orthopaedic Surgery, Middlemore Hospital, Auckland, New Zealand. · Department of Rheumatology, Mater Misericordiae University Hospital, Dublin, Ireland. · Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand. ·Ann Rheum Dis · Pubmed #24709860.

ABSTRACT: OBJECTIVES: Advanced imaging studies have demonstrated that urate deposition in periarticular structures, such as tendons, is common in gout. The aim of this study was to investigate the effects of monosodium urate monohydrate (MSU) crystals on tenocyte viability and function. METHODS: The histological appearance of tendons in joints affected by advanced gout was examined using light microscopy. In vitro, colorimetric assays and flow cytometry were used to assess cell viability in primary rat and primary human tenocytes cultured with MSU crystals. Real-time PCR was used to determine changes in the relative mRNA expression levels of tendon-related genes, and Sirius red staining was used to measure changes in collagen deposition in primary rat tenocytes. RESULTS: In joint samples from patients with gout, MSU crystals were identified within the tendon, adjacent to and invading into tendon, and at the enthesis. MSU crystals reduced tenocyte viability in a dose-dependent manner. MSU crystals decreased the mRNA expression of tendon collagens, matrix proteins and degradative enzymes and reduced collagen protein deposition by tenocytes. CONCLUSIONS: These data indicate that MSU crystals directly interact with tenocytes to reduce cell viability and function. These interactions may contribute to tendon damage in people with advanced gout.

11 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.

12 Article New approaches in the detection of calcium-containing microcrystals in synovial fluid. 2011

Hernandez-Santana, Aaron / Yavorskyy, Alexander / Loughran, Sinéad T / McCarthy, Geraldine M / McMahon, Gillian P. ·Bioanalytical Chemistry & Diagnostics Group, School of Chemical Sciences, Dublin City University, Ireland. ·Bioanalysis · Pubmed #21585303.

ABSTRACT: BACKGROUND: The presence of calcium phosphate crystals such as basic calcium phosphate and calcium pyrophosphate dihydrate in intra-articular fluid is linked to a number of destructive arthropathies and detection of these deposits is often pivotal for early diagnosis and appropriate management of such disease. RESULTS: We describe the use of a calcium-sensitive dye, Fluo-4, to selectively label calcium-containing mineral deposits in synovial fluid, which can then be easily visualized using a standard fluorescence microscope. Furthermore, we have combined the fluorescent properties of the tagged crystals with flow cytometry as a fast and semi-quantitative method of detection. CONCLUSION: Dot-plots were used to quantify differences between various types of arthropathies and confirmed by visual observation of the crystals under a fluorescence microscope.

13 Article A survey of the management of gout in primary care. 2008

Owens, D / Whelan, B / McCarthy, G. ·Department of Rheumatology, Mater Misericordiae Hospital, Dublin. daowens@eircom.net ·Ir Med J · Pubmed #18624262.

ABSTRACT: There is no information available regarding current practice and standards in management of gout in Irish general practice. This study aims to assess current practice in the context of the 2006 EULAR evidence based recommendations for diagnosis and management of gout. A 20 point questionnaire was circulated to all 170 general practitioners in the North Dublin GP Partnership assessing frequency of diagnostic and therapeutic interventions undertaken. 91% of practitioners manage gout exclusively in primary care. 89% make a diagnosis on clinical grounds and 77% routinely measure serum urate. Diagnostic joint aspiration is rarely performed (3%). 86% routinely assess and manage risk factors for gout. 66% initiate urate-lowering therapy. Only 32% routinely monitor urate levels in patients receiving urate-lowering therapy. Thus, although management of gout in primary care in Ireland is generally in line with the EULAR recommendations some aspects of care remain suboptimal.