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Gout: HELP
Articles from United Kingdom
Based on 191 articles published since 2008
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These are the 191 published articles about Gout that originated from United Kingdom during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Guideline The British Society for Rheumatology Guideline for the Management of Gout. 2017

Hui, Michelle / Carr, Alison / Cameron, Stewart / Davenport, Graham / Doherty, Michael / Forrester, Harry / Jenkins, Wendy / Jordan, Kelsey M / Mallen, Christian D / McDonald, Thomas M / Nuki, George / Pywell, Anthony / Zhang, Weiya / Roddy, Edward / Anonymous6680907. ·Department of Rheumatology, Derby Teaching Hospitals NHS Foundation Trust, Derby. · Hamell1st Floor Dome Building, The Quadrant, Richmond, TW9 1DT UK. · Renal Medicine, Guy's Campus, Kings College London, London. · Research Institute for Primary Care and Health Sciences, Keele University, Keele. · Academic Rheumatology, University of Nottingham, Nottingham. · Rheumatology, Brighton and Sussex University Hospitals NHS Trust, Brighton. · Medicines Monitoring Unit, Ninewells Hospital and Medical School, Dundee. · Institute for Genetics and Molecular Medicine, University of Edinburgh, Edinburgh. · Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Stoke-on-Trent, UK. ·Rheumatology (Oxford) · Pubmed #28549195.

ABSTRACT: -- No abstract --

2 Guideline The British Society for Rheumatology Guideline for the Management of Gout. 2017

Hui, Michelle / Carr, Alison / Cameron, Stewart / Davenport, Graham / Doherty, Michael / Forrester, Harry / Jenkins, Wendy / Jordan, Kelsey M / Mallen, Christian D / McDonald, Thomas M / Nuki, George / Pywell, Anthony / Zhang, Weiya / Roddy, Edward / Anonymous6650907. ·Department of Rheumatology, Derby Teaching Hospitals NHS Foundation Trust, Derby. · Hamell,1st Floor Dome Building, The Quadrant, Richmond TW9 1DT, UK. · Renal Medicine, Guy's Campus, Kings College London, London. · Research Institute for Primary Care and Health Sciences, Keele University, Keele. · Academic Rheumatology, University of Nottingham, Nottingham. · Rheumatology, Brighton and Sussex University Hospitals NHS Trust, Brighton. · Medicines Monitoring Unit, Ninewells Hospital and Medical School, Dundee. · Institute for Genetics and Molecular Medicine, University of Edinburgh. · Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership NHS Trust, Stoke-on-Trent, UK. ·Rheumatology (Oxford) · Pubmed #28549177.

ABSTRACT: -- No abstract --

3 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.

4 Editorial The role of diet in serum urate concentration. 2018

Watson, Lorraine / Roddy, Edward. ·Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire ST5 5BG, UK l.watson@keele.ac.uk. · Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Staffordshire ST5 5BG, UK. ·BMJ · Pubmed #30305276.

ABSTRACT: -- No abstract --

5 Editorial Incident gout and erectile dysfunction: is hyperuricaemia the elephant in the room? 2017

Abhishek, Abhishek / Doherty, Michael. ·Academic Rheumatology, Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK. Abhishek.abhishek@nottingham.ac.uk. · Academic Rheumatology, Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK. ·Arthritis Res Ther · Pubmed #28797283.

ABSTRACT: The first prospective population-based study to examine risk of erectile dysfunction in men with gout in the western world has been published. It reports that following their first diagnosis of gout, men have a 31% higher risk of erectile dysfunction than matched controls, although the absolute increase in risk is small. Of interest, the incidence of erectile dysfunction reported in this study is tenfold higher than those reported in nation-wide cohort studies from Taiwan. There is a need for further prospective cohort studies to examine the possible mechanistic association between gout, hyperuricaemia and erectile dysfunction.

6 Editorial The Economic Value of Genetic Testing for Tolerance of Allopurinol in Gout. 2017

Shields, Gemma Elizabeth. ·Research Fellow, Centre for Health Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, University of Manchester, Oxford Road, Manchester M13 9PL, UK. gemma.shields@manchester.ac.uk. ·J Rheumatol · Pubmed #28572472.

ABSTRACT: -- No abstract --

7 Editorial One step forward, five steps back? The re-emergence of Victorian diseases in the UK. 2016

Lee, Geraldine A. ·Florence Nightingale Faculty of Nursing & Midwifery, King's College London, 57 Waterloo Road, London SE1 8WA, UK. Electronic address: Gerry.lee@kcl.ac.uk. ·Int Emerg Nurs · Pubmed #27406398.

ABSTRACT: -- No abstract --

8 Review Crystallising the role of adrenocorticotrophic hormone in the management of acute gout: a review. 2019

Nisar, Muhammad K. ·Luton and Dunstable University Hospital NHSFT, Luton, UK. muhammad.nisar@ldh.nhs.uk. ·Clin Exp Rheumatol · Pubmed #30183601.

ABSTRACT: OBJECTIVES: Acute gout is traditionally treated with NSAIDs, corticosteroids, and colchicine. However, the presence of comorbid conditions and advancing age, often seen in hospitalised patients, may prevent their use. We reviewed the published data on the use of ACTH in the treatment of acute gouty arthritis. METHODS: A search was performed up to June 2017. We included clinical trials or case studies/series where ACTH had been administered in human subjects as a treatment for acute gout or pseudogout. RESULTS: Data consistently demonstrated ACTH to be fast-acting, typically relieving the painful symptoms of acute gout within 24 h of treatment. Furthermore, the average number of days needed to achieve 100% resolution of gout symptoms in patients treated with ACTH was similar to those of the corticosteroid triamcinolone. Retrospective data confirm the efficacy of ACTH or the synthetic analogue Synacthen in the treatment of acute gout in patients with comorbidities such as cardiovascular disease, chronic kidney disease, and hypertension, including those who were hospitalised, with all patients responding after 1-3 doses. ACTH appears to be well-tolerated with side effects being minor and transient in nature. Importantly, ACTH/Synacthen has no clinically significant effect on glucose and potassium levels or blood pressure. Clinical evidence from available case studies supports these findings. CONCLUSIONS: ACTH is a fast acting, efficacious and well-tolerated option for patients with acute gout when traditional therapies have failed or are contraindicated. However, large, carefully designed, randomised controlled trials are required to confirm these findings.

9 Review Advanced Imaging in the Diagnosis of Gout and Other Crystal Arthropathies. 2018

Teh, James / McQueen, Fiona / Eshed, Iris / Plagou, Athena / Klauser, Andrea. ·Department of Radiology, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust, Oxford, United Kingdom. · Department of Molecular Medicine and Pathology, University of Auckland, Auckland, New Zealand. · Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel. · Department of Radiology, Private Institution of Ultrasonography, Athens, Greece. · Department of Radiology, Medical University of Innsbruck, Innsbruck, Austria. ·Semin Musculoskelet Radiol · Pubmed #29672810.

ABSTRACT: In recent years significant advances have been made in imaging techniques. Dual-energy computed tomography has revolutionized the ability to detect and quantify gout. The key ultrasound features of gout have been defined. Magnetic resonance imaging is an excellent modality for demonstrating the extent and severity of crystal arthropathies, but the findings may be nonspecific. This article summarizes the use of advanced imaging techniques in the diagnosis and assessment of gout and other crystal arthropathies.

10 Review Are Doctors the Best People to Manage Gout? Is There a Role for Nurses and Pharmacists? 2018

Latif, Zahira / Abhishek, Abhishek. ·Academic Rheumatology, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building, Nottingham, NG5 1PB, UK. · Academic Rheumatology, University of Nottingham, Nottingham City Hospital, Clinical Sciences Building, Nottingham, NG5 1PB, UK. Abhishek.abhishek@nottingham.ac.uk. ·Curr Rheumatol Rep · Pubmed #29516289.

ABSTRACT: PURPOSE OF REVIEW: To discuss alternate models of long-term gout management RECENT FINDINGS: Nurse-led care of gout appears to improve the uptake of and adherence to urate-lowering treatment in a research setting. Less impressive improvements were achieved with pharmacist-led remote management of gout; however, both strategies were more effective than usual primary care provider management of gout. Individualised education about gout, patient involvement in decision-making, and access to trained support in managing side-effects and gout flares can improve the uptake of fine and adherence to urate-lowering treatment. This may be best achieved with nurse-led care of gout. However, further research is required to evaluate if the model of nurse-led care of gout can be implemented in routine clinical practice and in different healthcare systems.

11 Review Treat to target in gout. 2018

Perez-Ruiz, Fernando / Moreno-Lledó, Aitana / Urionagüena, Irati / Dickson, Alastair J. ·Rheumatology Division, Hospital Universitario Cruces, Biocruces Health Research Institute, and University of the Basque Country. · Family physician, Las Arenas Healthcare Centre, Biscay, Spain. · Primary Care Rheumatology Society & Honorary Associate, Centre of Health Economics, University of York, UK. ·Rheumatology (Oxford) · Pubmed #29272512.

ABSTRACT: The treat-to-target (T2T) approach has been successfully implemented in a number of diseases. T2T has been proposed for rheumatic diseases such as RA, spondyloarthritis, lupus, and recently for gout. The level of evidence for such approaches differs from one condition to the other (moderate to high for hyperlipidaemia, for example). Practice is based on the best available evidence at any time, and in absence of good evidence for T2T in gout, some suggest a conservative only-treat-symptoms approach. Evidence suggests that not treating gout to target in the long term is overall associated with worsening outcomes, such as flares, tophi and structural damage, which is associated to loss of quality of life and mortality. Different targets have been proposed for hyperuricaemia in gout; lower than 6 mg/dl (0.36 mmol/l) for all patients, at least <5 mg/dl (0.30 mmol/l) for patients with severe-polyarticular or tophaceous-gout.

12 Review Education and non-pharmacological approaches for gout. 2018

Abhishek, Abhishek / Doherty, Michael. ·Academic Rheumatology, University of Nottingham, Nottingham City Hospital, Nottingham, UK. ·Rheumatology (Oxford) · Pubmed #29272507.

ABSTRACT: The objectives of this review are as follows: to highlight the gaps in patient and physician knowledge of gout and how this might impede optimal disease management; to provide recommended core knowledge points that should be conveyed to people with gout; and to review non-pharmacological interventions that can be used in gout management. MeSH terms were used to identify eligible studies examining patients' and health-care professionals' knowledge about gout and its management. A narrative review of non-pharmacological management of gout is provided. Many health-care professionals have significant gaps in their knowledge about gout that have the potential to impede optimal management. Likewise, people with gout and the general population lack knowledge about causes, consequences and treatment of this condition. Full explanation about gout, including the potential benefits of urate-lowering treatment (ULT), motivates people with gout to want to start such treatment, and there is evidence, albeit limited, that educational interventions can improve uptake and adherence to ULT. Additionally, several non-pharmacological approaches, such as rest and topical ice application for acute attacks, avoidance of risk factors that can trigger acute attacks, and dietary interventions that may reduce gout attack frequency (e.g. cherry or cherry juice extract, skimmed milk powder or omega-3 fatty acid intake) or lower serum uric acid (e.g. vitamin C), can be used as adjuncts to ULT. There is a pressing need to educate health-care professionals, people with gout and society at large to remove the negative stereotypes associated with gout, which serve as barriers to optimal gout management, and to perceive gout as a significant medical condition. Moreover, there is a paucity of high-quality trial evidence on whether certain simple individual dietary and lifestyle factors can reduce the risk of recurrent gout attacks, and further studies are required in this field.

13 Review New urate-lowing therapies. 2018

Abhishek, Abhishek. ·Division of Rheumatology, Orthopaedics, and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK. ·Curr Opin Rheumatol · Pubmed #29251661.

ABSTRACT: PURPOSE OF REVIEW: To discuss recent studies of lesinurad and arhalofenate. RECENT FINDINGS: Lesinurad acts by blocking urate reabsorption channels URAT-1 and OAT-4. It has urate-lowering effect when used alone and in combination with xanthine oxidase inhibitors (XOIs). Its uricosuric activity depends on glomerular filtration, and its' efficacy is impaired at eGFR less than 30 ml/min. Lesinurad monotherapy (400 mg/day) associates with serum creatinine elevations. However, this risk is substantially attenuated with coprescription of a XOI and when prescribed at a dose of 200 mg/day. Given its' modest urate-lowering effect, and the risk of serum creatinine elevation when used alone, it is licenced for use in combination with XOI for people unable to achieve target serum uric acid with XOI alone. Lesinurad does not have the drug interactions associated with probenecid, however, it is metabolized by CYP2C9, and should be used with caution if CYP2C9 inhibitors are coprescribed. Arhalofenate also acts by blocking URAT-1; however, it also blocks the NALP-3 inflammasome providing gout-specific anti-inflammatory effect. Arhalofenate has a weaker urate-lowering effect than lesinurad and further phase III evaluation is planned. SUMMARY: Lesinurad provides an additional option for people with gout unable to achieve target serum uric acid with XOI alone.

14 Review Recent pharmacological advances in the management of gout. 2018

Davies, Kristen / Bukhari, Marwan A S. ·Faculty of Health and Medicine, Lancaster University, Lancaster, UK. · Department of Rheumatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Royal Lancaster Infirmary, Lancaster, UK. ·Rheumatology (Oxford) · Pubmed #28968896.

ABSTRACT: Gout is the most common cause of inflammatory arthritis worldwide, and reports show that despite availability of therapies, management is still suboptimal. The new EULAR 2016 recommendations for the treatment of gout highlight the huge development in gout therapies, and the number of drugs being trialled only continues to increase. A clinical review of the evidence that underlies the recommendations from EULAR can reveal possible gaps in the literature and avenues for future research into gout therapies.

15 Review BET 1: Prednisolone for the treatment of acute gouty arthritis. 2017

Simon Taylor, Richard. ·Royal Preston Hospital, Preston UK and Manchester Royal Infirmary, Manchester, UK. ·Emerg Med J · Pubmed #28963379.

ABSTRACT: A short cut review was carried out to establish whether corticosteroids are safe and effective in managing the symptoms of acute gouty arthritis. Five studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that corticosteroids are an effective and safe alternative to non steroidal anti inflammatory drugs (NSAIDs) in patients presenting with acute gouty arthritis.

16 Review Cost effectiveness analysis of HLA-B*58:01 genotyping prior to initiation of allopurinol for gout. 2017

Plumpton, Catrin O / Alfirevic, Ana / Pirmohamed, Munir / Hughes, Dyfrig A. ·Centre for Health Economics and Medicines Evaluation, Bangor University, Wales. · Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK. ·Rheumatology (Oxford) · Pubmed #28957559.

ABSTRACT: Objective: To determine whether prospective testing for HLA-B*58:01, as a strategy to prevent serious adverse reactions to allopurinol in patients with gout, is cost-effective from the perspective of the National Health Service in the UK. Methods: A systematic review and meta-analysis for the association of HLA-B*58:01 with cutaneous and hypersensitivity adverse drug reactions informed a decision analytic and Markov model to estimate lifetime costs and outcomes associated with testing vs standard care (with febuxostat prescribed for patients who test positive). Scenario analyses assessed alternative treatment assumptions and patient populations. Results: The number of patients needed to test to prevent one case of adverse drug reaction was 11 286 (95% central range (CR): 2573, 53 594). Cost and quality-adjusted life-year (QALY) gains were small, £103 (95% CR: £98, £106) and 0.0023 (95% CR: -0.0006, 0.0055), respectively, resulting in an incremental cost-effectiveness ratio (ICER) of £44 954 per QALY gained. The probability of testing being cost-effective at a threshold of £30 000 per QALY was 0.25. Reduced costs of testing or febuxostat resulted in an ICER below £30 000 per QALY gained. The ICER for patients with chronic renal insufficiency was £38 478 per QALY gained. Conclusion: Routine testing for HLA-B*58:01 in order to reduce the incidence of adverse drug reactions in patients being prescribed allopurinol for gout is unlikely to be cost-effective in the UK; however testing is expected to become cost-effective with reductions in the cost of genotyping, and with the future availability of cheaper, generic febuxostat.

17 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.

18 Review Conventional Radiology in Crystal Arthritis: Gout, Calcium Pyrophosphate Deposition, and Basic Calcium Phosphate Crystals. 2017

Jacques, Thibaut / Michelin, Paul / Badr, Sammy / Nasuto, Michelangelo / Lefebvre, Guillaume / Larkman, Neal / Cotten, Anne. ·Division of Radiology and Musculoskeletal Imaging, University Hospital of Lille, Rue du Professeur Emile Laine, Lille Cedex 59037, France; University of Lille, 42, rue Paul Duez, Lille 59000, France. Electronic address: thib.jacques@gmail.com. · Department of Radiology, CHRU de Rouen, 1 rue de Germont, Rouen Cedex 76031, France. · Division of Radiology and Musculoskeletal Imaging, University Hospital of Lille, Rue du Professeur Emile Laine, Lille Cedex 59037, France; University of Lille, 42, rue Paul Duez, Lille 59000, France. · Department of Radiology, University of Foggia, Viale Luigi Pinto 1, Foggia 71100, Italy. · Department of Radiology, Leeds Teaching Hospital Trust, Chapeltown Road, Leeds, West Yorkshire LS7 4SA, UK. ·Radiol Clin North Am · Pubmed #28774457.

ABSTRACT: This article reviews the main radiographic features of crystal deposition diseases. Gout is linked to monosodium urate crystals. Classic radiographic features include subcutaneous tophi, large and well-circumscribed paraarticular bone erosions, and exuberant bone hyperostosis. Calcium pyrophosphate deposition (CPPD) can involve numerous structures, such as hyaline cartilages, fibrocartilages, or tendons. CPPD arthropathy involves joints usually spared by osteoarthritis. Basic calcium phosphate deposits are periarticular or intraarticular. Periarticular calcifications are amorphous, dense, and round or oval with well-limited borders, and most are asymptomatic. When resorbing, they become cloudy and less dense with an ill-defined shape and can migrate into adjacent structures.

19 Review Serum uric acid levels and multiple health outcomes: umbrella review of evidence from observational studies, randomised controlled trials, and Mendelian randomisation studies. 2017

Li, Xue / Meng, Xiangrui / Timofeeva, Maria / Tzoulaki, Ioanna / Tsilidis, Konstantinos K / Ioannidis, John PA / Campbell, Harry / Theodoratou, Evropi. ·Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH8 9AG, UK. · Colon Cancer Genetics Group, Medical Research Council Human Genetics Unit, Medical Research Council Institute of Genetics & Molecular Medicine, University of Edinburgh, Edinburgh, UK. · Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK. · Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece. · Stanford Prevention Research Center, Stanford School of Medicine, Stanford, CA, USA. · Department of Health Research and Policy, Stanford School of Medicine, Stanford, CA, USA. · Department of Statistics, Stanford University, Stanford, CA, USA. · Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH8 9AG, UK E.Theodoratou@ed.ac.uk. ·BMJ · Pubmed #28592419.

ABSTRACT:

20 Review Interleukin-1 Blockade: An Update on Emerging Indications. 2017

Mistry, Anoop / Savic, Sinisa / van der Hilst, Jeroen C H. ·Department of Clinical Immunology and Allergy, St. James's University Hospital, Wellcome Trust Brenner Building, Beckett Street, Leeds, UK. · NIH Research-Leeds Musculoskeletal Biomedical Research Unit (NIHR-LMBRU), St. James's University Hospital, Wellcome Trust Brenner Building, Beckett Street, Leeds, UK. · Leeds Institute of Rheumatic and Musculoskeletal Medicine (LIRMM), St. James's University Hospital, Wellcome Trust Brenner Building, Beckett Street, Leeds, UK. · Department of Infectious Diseases and Immunity, Jessa Hospital, Stadsomvaat 11, 3500, Hasselt, Belgium. jeroen.vanderhilst@jessazh.be. · BIOMED Research Institute, University of Hasselt, Hasselt, Belgium. jeroen.vanderhilst@jessazh.be. ·BioDrugs · Pubmed #28497222.

ABSTRACT: Interleukin (IL)-1 is a pro-inflammatory cytokine that induces local and systemic inflammation aimed to eliminate microorganisms and tissue damage. However, an increasing number of clinical conditions have been identified in which IL-1 production is considered inappropriate and IL-1 is part of the disease etiology. In autoinflammatory diseases, gout, Schnitzler's syndrome, and adult-onset Still's disease, high levels of inappropriate IL-1 production have been shown to be a key process in the etiology of the disease. In these conditions, blocking IL-1 has proven very effective in clinical studies. In other diseases, IL-1 has shown to be present in disease process but is not the central driving force of inflammation. In these conditions, including type 1 and 2 diabetes mellitus, acute coronary syndrome, amyotrophic lateral sclerosis, and several neoplastic diseases, the benefits of IL-1 blockade are minimal or absent.

21 Review Gout - a guide for the general and acute physicians. 2017

Abhishek, Abhishek / Roddy, Edward / Doherty, Michael. ·University of Nottingham, Nottingham, UK Abhishek.abhishek@nottingham.ac.uk. · Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK. · University of Nottingham, Nottingham, UK. ·Clin Med (Lond) · Pubmed #28148582.

ABSTRACT: Gout is the most prevalent inflammatory arthritis and affects 2.5% of the general population in the UK. It is also the only arthritis that has the potential to be cured with safe, inexpensive and well tolerated urate-lowering treatments, which reduce serum uric acid by either inhibiting xanthine oxidase - eg allopurinol, febuxostat - or by increasing the renal excretion of uric acid. Of these, xanthine oxidase inhibitors are used first line and are effective in 'curing' gout in the vast majority of patients. Gout can be diagnosed on clinical grounds in those with typical podagra. However, in those with involvement of other joints, joint aspiration is recommended to demonstrate monosodium urate crystals and exclude other causes of acute arthritis, such as septic arthritis. However, a clinical diagnosis of gout can be made if joint aspiration is not feasible. This review summarises the current understanding of the pathophysiology, clinical presentation, investigations and treatment of gout.

22 Review Does the initiation of urate-lowering treatment during an acute gout attack prolong the current episode and precipitate recurrent attacks: a systematic literature review. 2016

Eminaga, Fatma / La-Crette, Jonathan / Jones, Adrian / Abhishek, A. ·Department of Medicine, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK. · Department of Medicine, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK. Abhishek.abhishek@nottingham.ac.uk. · Academic Rheumatology, Clinical Sciences Building, University of Nottingham, Nottingham, NG5 1PB, UK. Abhishek.abhishek@nottingham.ac.uk. ·Rheumatol Int · Pubmed #27761603.

ABSTRACT: The aim of this study was to systematically review the literature on effect of initiating urate-lowering treatment (ULT) during an acute attack of gout on duration of index attack and persistence on ULT. OVID (Medline), EMBASE and AMED were searched to identify randomized controlled trials (RCTs) of ULT initiation during acute gout attack published in English language. Two reviewers appraised the study quality and extracted data independently. Standardized mean difference (SMD) and relative risk (RR) were used to pool continuous and categorical data. Meta-analysis was carried out using STATA version 14. A total of 537 studies were selected. A total of 487 titles and abstracts were reviewed after removing duplicates. Three RCTs were identified. There was evidence from two high-quality studies that early initiation of allopurinol did not increase pain severity at days 10-15 [SMD

23 Review From juvenile hyperuricaemia to dysfunctional uromodulin: an ongoing metamorphosis. 2016

Venkat-Raman, Gopalakrishnan / Gast, Christine / Marinaki, Anthony / Fairbanks, Lynnette. ·Wessex Kidney Centre & University of Southampton, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK. gvr@porthosp.nhs.uk. · Wessex Kidney Centre & University of Southampton, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK. · Purine Research Laboratory, St Thomas' Hospital, London, UK. ·Pediatr Nephrol · Pubmed #26872483.

ABSTRACT: Familial juvenile hyperuricaemic nephropathy (FJHN) is a diagnosis that is easily missed. It has taken a long time to clarify the pathophysiology and prevalence of this disease entity which has been shown to be genetically identical to medullary cystic kidney disease (MCKD) type II. The initial suspicion that uric acid was the noxious agent has been replaced by the recognition that a mutant uromodulin (UMOD) is the real culprit-although the exact mechanisms of pathogenicity remain uncertain. The mutation has been traced to the UMOD gene in chromosome 16. The disease is characterised by the classic triad of autosomal dominant inheritance, progressive renal failure beginning in the third to fifth decade of life and gout. Phenotypically similar but genotypically distinct entities have been described over the last 10 years, making a clinical diagnosis difficult. These include mutations in the renin, hepatocyte nuclear factor 1-β and mucin 1 genes. UMOD-associated kidney disease has been proposed as a logical diagnostic label to replace FJHN, but given all these other mutations, an over-arching diagnostic term of 'autosomal dominant tubulointerstitial kidney disease' (ADTKD) has been recently adopted. Allopurinol has been suggested as a therapeutic agent, but unfortunately this was based on non-randomised uncontrolled trials with small patient numbers.

24 Review Global epidemiology of gout: prevalence, incidence and risk factors. 2015

Kuo, Chang-Fu / Grainge, Matthew J / Zhang, Weiya / Doherty, Michael. ·Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, 5, Fu-Hsing Street, Taoyuan 333, Taiwan. · Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK. · Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham NG5 1PB, UK. ·Nat Rev Rheumatol · Pubmed #26150127.

ABSTRACT: Gout is a crystal-deposition disease that results from chronic elevation of uric acid levels above the saturation point for monosodium urate (MSU) crystal formation. Initial presentation is mainly severely painful episodes of peripheral joint synovitis (acute self-limiting 'attacks') but joint damage and deformity, chronic usage-related pain and subcutaneous tophus deposition can eventually develop. The global burden of gout is substantial and seems to be increasing in many parts of the world over the past 50 years. However, methodological differences impair the comparison of gout epidemiology between countries. In this comprehensive Review, data from epidemiological studies from diverse regions of the world are synthesized to depict the geographic variation in gout prevalence and incidence. Key advances in the understanding of factors associated with increased risk of gout are also summarized. The collected data indicate that the distribution of gout is uneven across the globe, with prevalence being highest in Pacific countries. Developed countries tend to have a higher burden of gout than developing countries, and seem to have increasing prevalence and incidence of the disease. Some ethnic groups are particularly susceptible to gout, supporting the importance of genetic predisposition. Socioeconomic and dietary factors, as well as comorbidities and medications that can influence uric acid levels and/or facilitate MSU crystal formation, are also important in determining the risk of developing clinically evident gout.

25 Review Pattern recognition receptors as potential therapeutic targets in inflammatory rheumatic disease. 2015

Mullen, Lisa M / Chamberlain, Giselle / Sacre, Sandra. ·Brighton and Sussex Medical School, Falmer, Brighton, BN1 9RY, UK. l.mullen@bsms.ac.uk. · Brighton and Sussex Medical School, Falmer, Brighton, BN1 9RY, UK. g.chamberlain@bsms.ac.uk. · Brighton and Sussex Medical School, Falmer, Brighton, BN1 9RY, UK. s.sacre@bsms.ac.uk. ·Arthritis Res Ther · Pubmed #25975607.

ABSTRACT: The pattern recognition receptors of the innate immune system are part of the first line of defence against pathogens. However, they also have the ability to respond to danger signals that are frequently elevated during tissue damage and at sites of inflammation. Inadvertent activation of pattern recognition receptors has been proposed to contribute to the pathogenesis of many conditions including inflammatory rheumatic diseases. Prolonged inflammation most often results in pain and damage to tissues. In particular, the Toll-like receptors and nucleotide-binding oligomerisation domain-like receptors that form inflammasomes have been postulated as key contributors to the inflammation observed in rheumatoid arthritis, osteoarthritis, gout and systemic lupus erythematosus. As such, there is increasing interest in targeting these receptors for therapeutic treatment in the clinic. Here the role of pattern recognition receptors in the pathogenesis of these diseases is discussed, with an update on the development of interventions to modulate the activity of these potential therapeutic targets.

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