Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Gout: HELP
Articles from University of Basel
Based on 19 articles published since 2010
||||

These are the 19 published articles about Gout that originated from University of Basel during 2010-2020.
 
+ Citations + Abstracts
1 Review [Uric acid, kidney disease and nephrolithiasis]. 2016

Kim, Min Jeong / Hopfer, Helmut / Mayr, Michael. ·1 Klinik für Ambulante Innere Medizin und Medizinische Poliklinik, Universitätsspital Basel. ·Ther Umsch · Pubmed #27008449.

ABSTRACT: Different types of kidney disease are known to be associated with hyperuricemia. The underlying pathophysiologic mechanisms strongly vary, and different ways of therapeutic approach are therefore required. In tumor lysis syndrome, a rapid, excessive increase of serum uric acid level can cause an acute renal failure. For chronic urate nephropathy, on the other hand, constantly elevated serum uric acid level for a longer period seems to be important. Being still controversial as a disease entity however, the aetiology for putative chronic urate nephropathy might be in fact chronic lead intoxication, as suggested by quite an amount of association data. In terms of uric acid nephrolithiasis, the major risk factor is a urinary acidification defect with persistently acidic urine pH, and not necessarily hyperuricemia or hyperuricosuria. Evidence suggests that metabolic diseases with increased insulin resistance are strongly associated with urinary acidification defect. Patients with uric acid kidney stones should therefore be thoroughly evaluated for such metabolic diseases and in a positive case adequately treated.

2 Review [Nutritional therapy of gout]. 2016

Nickolai, Beate / Kiss, Caroline. ·1 Ernährungsberatung, Universitätsspital Basel. ·Ther Umsch · Pubmed #27008448.

ABSTRACT: Nutrition and nutritional behaviours have been found to play a major role in the development of gout. Studies show that body mass index (BMI), as well as excessive intake of alcoholic beverages, meat, soft drinks and fruit juices increase the risk of developing gout. Similarly, dairy products and coffee have been seen to decrease the risk of hyperuricemia and gout, as they increase the excretion of uric acid. Flares of gout are often caused by large meals and high alcohol consumption. Each additional intake of meat portion per day increases the risk of gout by 21 %. Taking total alcohol consumption into account, the risk of gout increases after one to two standard drinks. In contrast to previous assumptions purine-rich plant foods like legumes and vegetables do not increase the risk of gout. The current dietary guidelines take into account nutritional factors, which not only consider purine intake, but also their endogenous production and their influence on renal excretion. A balanced diet based on the Swiss healthy eating guideline pyramid as well as the Mediterranean diet is appropriate for this patient population. The treatment of gout is multi-faceted, since this patient population presents other comorbidities such as obesity, diabetes mellitus, dyslipidemia and hypertension. Collectively, these risk factors are diet dependent and require a treatment strategy that is centered on modifying one's nutrition and nutritional behaviours. The aim of such therapy is to educate the patient as well as treat the accompanying comorbidities with the goal of decreasing serum uric acid values. Motivated patients require consultation and follow-up care in order to be able to actively decrease the serum uric acid.

3 Review [Causes, mechanisms and possible therapeutic targets of gout]. 2016

Manigold, Tobias. ·1 Abteilung für Rheumatologie, Universitätsspital Basel. ·Ther Umsch · Pubmed #27008447.

ABSTRACT: Gout is the most frequent arthritis worldwide with increasing prevalence in industrialized countries and massive socioeconomic consequences. The knowledge regarding the pathomechanisms which lead to arthritis has substantially increased during the last decade. Consistently, new therapeutic approaches and substances appear at the horizon. This review covers aspects of clinical presentation, diagnosis and current treatment. The pathomechanisms leading to NLRP3 inflammasome activation and IL-1beta secretion are reviewed in detail. Finally, selected new therapeutic targets and substances are discussed.

4 Review [Hyperuricemia, gout and cardiovascular diseases]. 2016

Murray, Karsten / Burkard, Thilo. ·1 Abteilung für Kardiologie, Universitätsspital Basel. · 2 Klinik für Ambulante Innere Medizin und Medizinische Poliklinik, Universitätsspital Basel. ·Ther Umsch · Pubmed #27008446.

ABSTRACT: Hyperuricemia, gout as well as arterial hypertension and metabolic syndrom are highly prevalent and clinicians are frequently confronted with both conditions in the same patient. Hyperuricemia and gout are associated with cardiovascular comorbidities and a high cardiovascular risk. Despite coherent pathophysiological concepts, it remains to be determined, if this association is independent and causal. In daily clinical practice, cardiovascular risk factors should be thoroughly identified and consequently treated in all patients with hyperuricemia and gout. If preventive treatment of asymptomatic hyperuricemia with urate-lowering agents may improve cardiovascular risk and outcomes remains to be determined and is recommended only in special situations like young patients with severe hyperuricemia.

5 Review [Histopathophysiology of Gout]. 2016

Hügle, Thomas / Krenn, Veit. ·1 Abteilung Rheumatologie, Universitätsspital Basel. · 2 MVZ-Zentrum für Histologie, Zytologie und Molekulare Diagnostik, Trier, Deutschland. ·Ther Umsch · Pubmed #27008445.

ABSTRACT: Despite being a frequent cause of arthritis and bone erosions, the underlying cellular and subcellular reaction in gout is insufficiently understood. The inflammasome as intracellular sensor for crystals plays an important role, notably resulting in interleukin (IL)-1 production. Morphologically, hyperplasia of the synovial membrane with joint effusion, along with fibrinogen deposition and influx of neutrophils and lymphocytes are observed. Extracellular NET formation by neutrophils is involved in the regulation of inflammatory tissue reaction. Furthermore, the release of IL-10 and tumor necrosis factor (TNF)-receptors along with lymphocyte proliferation induce the natural resolution of acute gouty arthritis which typically occurs after several days. In contrast to acute gout, tophi consisting of urate crystals are surrounded by histiocytes and multinucleated cells, resembling a foreign body reaction. The deposition of extracellular matrix by fibrocytes is usually observed around tophi. This fibrotic reaction is likely enhanced by Th2-lymphocytes. Bone erosions in gout occur around tophi and are triggered by osteoclast activation through RANK-ligand expression by lymphocytes. In conclusion, understanding the orchestration of inflammation in gout might help to identify new therapeutic targets.

6 Review [Imaging findings of cristal deposit disorders]. 2016

Hirschmann, Anna / Studler, Ueli. ·1 Klinik für Radiologie und Nuklearmedizin, Universitätsspital Basel. · 2 Röntgeninstitut Imamed Radiologie Nordwest. ·Ther Umsch · Pubmed #27008444.

ABSTRACT: Cristal deposit disorders are characterised by cristal deposits in hyaline and fibrocartilage, in synovium, capsule, ligaments and tendons and periarticular soft tissue. Calciumpyrophosphatedihydrate (CPPD), hydroxyapatite (calcific tendinitis) and uric acid arthropathies are the most common cristal deposit diseases. Radiography is still the number one image modality for initial imaging and the identification of cristal-induced inflammatory arthropathies. Differentiation between the entities of cristal deposit arthropathies can be challenging. Clincial and radiological findings may overlap in different cristal deposit arthropathies, owing a certain diagnosis difficult.

7 Review [Current epidemiology of gout]. 2016

Ankli, Barbara. ·1 Klinik für Rheumatologie, Universitätsspital Basel. · 2 Klinik für Rheumatologie, Bethesda-Spital Basel. ·Ther Umsch · Pubmed #27008443.

ABSTRACT: Gout is the most common inflammatory arthritis in adults nowadays. Prevalence has risen over the last decades. Patients over 65 years are disproportionally affected. A male/female ratio of 4:1 is diminishing after menopause (still 3:1). The relative risk of developing gout increases in a linear progression with the serum uric acid level. Other risk factors beside hyperuricemia are genetic predisposition, age, male gender, adipositas, lifestyle modification, chronic kidney disease and intake of diuretics. Many gout patients suffer from comorbidities. The metabolic syndrome is associated with gout. Two fifths of patients with gout had also chronic kidney disease. Reasons for the rise in prevalence are longevity, dietary habits and the high prevalence of patients with chronic kidney disease in the general population.

8 Review [Gout management: an update]. 2016

Ankli, Barbara / Krähenbühl, Stephan. ·1 Klinik für Rheumatologie, Universitätsspital Basel. · 2 Klinik für Rheumatologie, Bethesda-Spital Basel. · 3 Klinik für Pharmakologie, Universitätsspital Basel. ·Ther Umsch · Pubmed #27008442.

ABSTRACT: Gout is the most frequent arthritis worldwide. Despite progress in therapeutic options the majority of gout patients are still insufficiently treated. International guidelines (ACR, EULAR, 3e initiative) clearly specify treatment targets: keep the patient flare-free and maintain a low urate serum level (< 360 µmol/l). The treat to target strategy includes therapy of flares, urate lowering treatment (ULT) and prophylaxis of flares. Evolution of gout guidelines over several years shows a broader indication for ULT, mandatory prophylaxis of flares during the initiation of ULT over several months and an earlier start of ULT in patients with flares as soon as symptoms have diminished. Colchicine is the preferred specific flare treatment, Caution has to be taken especially in patients with kidney disease, patients with hepatic dysfunction or in patients with interacting comedication. Low dose oral colchicine is nowadays the standard flare treatment. NSAIDs and prednisone are valuable alternatives. Interleukin-1 blockers offer a quick resolution of flares and may be an option in patients with chronic gout and severe kidney disease. Xanthinoxidase inhibitors (XOI) are the mainstay of ULT, with allopurinol still being the preferred XOI. The recently approved XOI febuxostat is eliminated mostly by the liver and can induce a faster lowering of urate. Uricosuric drugs such as probenecid are recommended in patients with sufficient renal function in whom the treatment goals cannot be reached with XOI. In Switzerland, only the two gout-lowering drugs allopurinol and probenecid are available, which reduces the therapeutic possibilities. Treatment success is often hampered by malcompliance. Recent guidelines stress the importance of patient education to ameliorate compliance. Comorbidities such as metabolic syndrome, cardiovascular and kidney disease are often found in gout patients. Patients with severe kidney disease are the most difficult to treat: the choice of antiinflammatory treatment is narrowed, ULT has to be uptitrated very carefully and patients often suffer from repeated flares. Another factor associated with treatment failure is the low physician’s adherence towards the guidelines. Therapeutic failure can lead to chronic and refractory gout (polyarticular gout, uncontrolled flare activity, chronic synovitis, destructive tophi) which makes the further management very difficult. Most gout patients are treated in primary care settings. Patients with chronic gout or at high risk for development of chronic gout (in particular patients with severe kidney disease or patients transplanted) should be additionally treated by a rheumatologist.

9 Article The Beneficence of Hope: Findings from a Qualitative Study with Gout and Diabetes Patients. 2018

Wienand, Isabelle / Rakic, Milenko / Shaw, David / Elger, Bernice. ·Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. isabelle.wienand@unibas.ch. · Institut für Bio- und Medizinethik, Universität Basel, Bernoullistrasse 28, Raum 002, -4056, Basel, CH, Switzerland. isabelle.wienand@unibas.ch. · Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland. ·J Bioeth Inq · Pubmed #29663121.

ABSTRACT: This paper explores the importance of hope as a determining factor for patients to participate in first-in-human trials for synthetic biology therapies. This paper focuses on different aspects of hope in the context of human health and well-being and explores the varieties of hope expressed by patients. The research findings are based on interview data collected from stable gout and diabetes patients. Three concepts of hope have emerged from the interviews: hope as certainty (H1); hope as reflective uncertainty (H2); hope as self-therapy (H3). The purpose of the paper is twofold. First, it aims to underline the significance of hope in patients' medical decision-making, as well as the beneficence of hope for patients' well-being, and for progress in research. Second, it shows how philosophical investigations-in particular Descartes-explore the phenomenon of hope and provide medical empirical research with profitable insights and tools.

10 Article Calcium pyrophosphate deposition disease: a frequent finding in patients with long-standing erosive gout. 2018

Ankli, B / Kyburz, D / Hirschmann, A / Hügle, T / Manigold, T / Berger, C T / Daikeler, T. ·a Department of Rheumatology , University Hospital Basel , Basel , Switzerland. · b Department of Radiology and Nuclear Medicine , University Hospital Basel , Basel , Switzerland. · c Translational Immunology and Medical Outpatient Clinic, Department of Biomedicine and Internal Medicine , University Hospital Basel , Basel , Switzerland. ·Scand J Rheumatol · Pubmed #28812408.

ABSTRACT: OBJECTIVE: To characterize patients with both monosodium urate (MSU) and calcium pyrophosphate (CPP) crystals in their synovial fluid (SF). METHOD: Forty-nine gout patients with acute arthritis were included. Those patients with MSU crystals only in their SF were compared to those patients with both MSU and CPP crystals in their SF. RESULTS: A total of 36 out of 49 patients (73.5%) had only MSU crystals, whereas 13 out of 49 (26.5%) had both MSU and CPP crystals in their SF. Co-deposition of CPP crystals was associated with long-standing gout disease (p = 0.022), kidney dysfunction (p = 0.024), and erosive arthritis (p = 0.049), but not with age. CONCLUSION: Long-standing gout may be a risk factor for CPP deposition disease, and the frequency of CPP co-deposition may be higher than expected.

11 Article Enhancing patients' autonomy by involving them in research ethics committees. 2017

Rakic, Milenko / Dittrich, Tolga / Elger, Bernice S / Shaw, David. ·Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland. ·Int J Qual Health Care · Pubmed #29077835.

ABSTRACT: Objective: Although clinical trial participants are the most affected by research ethics committee's decisions, they are not formally represented on Swiss committees. We aimed to find out what patients think about the idea of being members of such committees. Design: Latent thematic analysis was used to analyse the interviews. Setting: Patients were recruited in a Swiss university hospital. Participants: The study involved 26 patients suffering from diabetes or gout. Interventions: We conducted semi-structured interviews. Main Outcome Measures: We explored what patients think of being established members of research ethics committees. Results: We identified three different attitudes among our participants regarding participation in research ethics committees: (i) positive attitude regarding the idea of being members of such committees, (ii) ambivalent attitude and (iii) negative attitude. Patients belonging to the first group (i) often mentioned that they wanted their health condition to be more visible. Patients from the second group (ii) mentioned positive as well as negative aspects. Patients from the third group (iii) said that patients in general did not have enough background knowledge to be able to gain an overview of a whole clinical trial. Conclusions: Our study adds important knowledge about the idea of patients becoming research ethics committee members by exploring their perceptions of being members. Stable patients tended to be interested in the idea of participation and some specific recommendations could be derived (patients could have an advisory instead of a decision-making role on committees). However, further studies with more patients and further quantitative research are needed.

12 Article [Uric acid and kidneys – Physiological and pathophysiological aspects]. 2016

Kim, Min Jeong / Mayr, Michael. ·1 Klinik für Ambulante Innere Medizin und Medizinische Poliklinik, Universitätsspital Basel. ·Ther Umsch · Pubmed #27008450.

ABSTRACT: Kidneys play a critical role in the excretion of uric acid. Improved knowledge of the renal tubular uric acid transport mechanisms helps to better understand, why hyper- or hypouricemia can develop without the external influence of purine intake. Besides the genetic mutations, several drugs and specific medical conditions can significantly influence the tubular excretion of uric acid and thus the serum uric acid level. It seems evident that the renal function per se has a relevant impact on the uric acid excretion. It is however not clear, whether uric acid has a causal role in the development of chronic kidney disease and if so, to what extent. In order to better understand the impact of hyper- and hypouricemia and especially their clinical relevance, further researches on the renal tubular physio- and pathophysiology and also high quality intervention studies are required.

13 Article Gouty Arthritis of the Atlantodental Joint. 2016

Manigold, Tobias / Hirschmann, Anna / Kybur, Diego / Daikeler, Thomas / Ankli, Barbara / Büttner, Franz. ·University Hospital Basel, Basel, Switzerland. · University Hospital Basel and Bethesdaspital, Basel, Switzerland. · Kantonsspital Liestal, Liestal, Switzerland. ·Arthritis Rheumatol · Pubmed #26881917.

ABSTRACT: -- No abstract --

14 Article Neutrophil microvesicles resolve gout by inhibiting C5a-mediated priming of the inflammasome. 2016

Cumpelik, Arun / Ankli, Barbara / Zecher, Daniel / Schifferli, Jürg A. ·Department of Biomedicine, University Hospital Basel, Basel, Switzerland Department of Medicine, University Hospital Basel, Basel, Switzerland. · Department of Rheumatology, University Hospital Basel, Basel, Switzerland. · Department of Biomedicine, University Hospital Basel, Basel, Switzerland Department of Medicine, University Hospital Basel, Basel, Switzerland Department of Nephrology, University Hospital Regensburg, Regensburg, Germany. ·Ann Rheum Dis · Pubmed #26245757.

ABSTRACT: OBJECTIVES: Gout is a highly inflammatory but self-limiting joint disease induced by the precipitation of monosodium urate (MSU) crystals. While it is well established that inflammasome activation by MSU mediates acute inflammation, little is known about the mechanism controlling its spontaneous resolution. The aim of this study was to analyse the role of neutrophil-derived microvesicles (PMN-Ecto) in the resolution of acute gout. METHODS: PMN-Ecto were studied in a murine model of MSU-induced peritonitis using C57BL/6, MerTK(-/-) and C5aR(-/-) mice. The peritoneal compartment was assessed for the number of infiltrating neutrophils (PMN), neutrophil microvesicles (PMN-Ecto), cytokines (interleukin-1β, TGFβ) and complement factors (C5a). Human PMN-Ecto were isolated from exudates of patients undergoing an acute gouty attack and functionally tested in vitro. RESULTS: C5a generated after the injection of MSU primed the inflammasome for IL-1β release. Neutrophils infiltrating the peritoneum in response to C5a released phosphatidylserine (PS)-positive PMN-Ecto early on in the course of inflammation. These PMN-Ecto in turn suppressed C5a priming of the inflammasome and consequently inhibited IL-1β release and neutrophil influx. PMN-Ecto-mediated suppression required surface expression of the PS-receptor MerTK and could be reproduced using PS-expressing liposomes. In addition, ectosomes triggered the release of TGFβ independent of MerTK. TGFβ, however, was not sufficient to control acute MSU-driven inflammation in vivo. Finally, PMN-Ecto from joint aspirates of patients with gouty arthritis had similar anti-inflammatory properties. CONCLUSIONS: PMN-Ecto-mediated control of inflammasome-driven inflammation is a compelling concept of autoregulation initiated early on during PMN activation in gout.

15 Article Association of hormone therapy and incident gout: population-based case-control study. 2015

Bruderer, Saskia G / Bodmer, Michael / Jick, Susan S / Meier, Christoph R. ·1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland 2Hospital Pharmacy, University Hospital Basel, Basel, Switzerland 3Division of General Internal Medicine, Bern University Hospital, Inselspital, Bern, Switzerland 4Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, MA. ·Menopause · Pubmed #25968834.

ABSTRACT: OBJECTIVE: This study aims to assess the odds of developing incident gout in association with the use of postmenopausal estrogen-progestogen therapy, according to type, timing, duration, and route of administration of estrogen-progestogen therapy. METHODS: We conducted a retrospective population-based case-control analysis using the United Kingdom-based Clinical Practice Research Datalink. We identified women (aged 45 y or older) who had a first-time diagnosis of gout recorded between 1990 and 2010. We matched one female control with each case on age, general practice, calendar time, and years of active history in the database. We used multivariate conditional logistic regression to calculate odds ratios (ORs) with 95% CIs (adjusted for confounders). RESULTS: The adjusted OR for gout with current use of oral formulations of opposed estrogens (estrogen-progestogen) was 0.69 (95% CI, 0.56-0.86) compared with never use. Current use was associated with a decreased OR for gout in women without renal failure (adjusted OR, 0.71; 95% CI, 0.57-0.87) and hypertension (adjusted OR, 0.62; 95% CI, 0.44-0.87) compared with never use. Tibolone was associated with a decreased OR for gout (adjusted OR, 0.77; 95% CI, 0.63-0.95) compared with never use. Estrogens alone did not alter the OR for gout. CONCLUSIONS: Current use of oral opposed estrogens, but not unopposed estrogens, is associated with a decreased OR for incident gout in women without renal failure and is more pronounced in women with hypertension. Use of tibolone is associated with a decreased OR for incident gout. The decreased OR for gout may be related to the progestogen component rather than the estrogen component.

16 Article Poorly controlled type 2 diabetes mellitus is associated with a decreased risk of incident gout: a population-based case-control study. 2015

Bruderer, Saskia G / Bodmer, Michael / Jick, Susan S / Meier, Christoph R. ·Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland Hospital Pharmacy, University Hospital Basel, Basel, Switzerland. · Division of General Internal Medicine, Bern University Hospital, Inselspital, Bern, Switzerland. · Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, Massachusetts, USA. · Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland Hospital Pharmacy, University Hospital Basel, Basel, Switzerland Boston Collaborative Drug Surveillance Program, Boston University School of Public Health, Lexington, Massachusetts, USA. ·Ann Rheum Dis · Pubmed #24728333.

ABSTRACT: OBJECTIVE: The aim of this study was to explore the risk of incident gout in patients with type 2 diabetes mellitus (T2DM) in association with diabetes duration, diabetes severity and antidiabetic drug treatment. METHODS: We conducted a case-control study in patients with T2DM using the UK-based Clinical Practice Research Datalink (CPRD). We identified case patients aged ≥18 years with an incident diagnosis of gout between 1990 and 2012. We matched to each case patient one gout-free control patient. We used conditional logistic regression analysis to calculate adjusted ORs (adj. ORs) with 95% CIs and adjusted our analyses for important potential confounders. RESULTS: The study encompassed 7536 T2DM cases with a first-time diagnosis of gout. Compared to a diabetes duration <1 year, prolonged diabetes duration (1-3, 3-6, 7-9 and ≥10 years) was associated with decreased adj. ORs of 0.91 (95% CI 0.79 to 1.04), 0.76 (95% CI 0.67 to 0.86), 0.70 (95% CI 0.61 to 0.86), and 0.58 (95% CI 0.51 to 0.66), respectively. Compared to a reference A1C level of <7%, the risk estimates of increasing A1C levels (7.0-7.9, 8.0-8.9 and ≥9%) steadily decreased with adj. ORs of 0.79 (95% CI 0.72 to 0.86), 0.63 (95% CI 0.55 to 0.72), and 0.46 (95% CI 0.40 to 0.53), respectively. Neither use of insulin, metformin, nor sulfonylureas was associated with an altered risk of incident gout. CONCLUSIONS: Increased A1C levels, but not use of antidiabetic drugs, was associated with a decreased risk of incident gout among patients with T2DM.

17 Article Use of diuretics and risk of incident gout: a population-based case-control study. 2014

Bruderer, Saskia / Bodmer, Michael / Jick, Susan S / Meier, Christoph R. ·University of Basel and University Hospital Basel, Basel, Switzerland. ·Arthritis Rheumatol · Pubmed #24449584.

ABSTRACT: OBJECTIVE: Use of diuretics has been associated with an increased risk of gout. Data on different types of diuretics are scarce. We undertook this study to investigate the association between use of loop diuretics, thiazide or thiazide-like diuretics, and potassium-sparing agents and the risk of developing incident gout. METHODS: We conducted a retrospective population-based case-control analysis using the General Practice Research Database established in the UK. We identified case patients who were diagnosed as having incident gout between 1990 and 2010. One control patient was matched to each case patient for age, sex, general practice, calendar time, and years of active history in the database. We used conditional logistic regression to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs), and we adjusted for potential confounders. RESULTS: We identified 91,530 incident cases of gout and the same number of matched controls. Compared to past use of diuretics from each respective drug class, adjusted ORs for current use of loop diuretics, thiazide diuretics, thiazide-like diuretics, and potassium-sparing diuretics were 2.64 (95% CI 2.47-2.83), 1.70 (95% CI 1.62-1.79), 2.30 (95% CI 1.95-2.70), and 1.06 (95% CI 0.91-1.23), respectively. Combined use of loop diuretics and thiazide diuretics was associated with the highest relative risk estimates of gout (adjusted OR 4.65 [95% CI 3.51-6.16]). Current use of calcium channel blockers or losartan slightly attenuated the risk of gout in patients who took diuretics. CONCLUSION: Use of loop diuretics, thiazide diuretics, and thiazide-like diuretics was associated with an increased risk of incident gout, although use of potassium-sparing agents was not.

18 Article Application of the OMERACT filter to measures of core outcome domains in recent clinical studies of acute gout. 2014

Taylor, William J / Redden, David / Dalbeth, Nicola / Schumacher, H Ralph / Edwards, N Lawrence / Simon, Lee S / John, Markus R / Essex, Margaret N / Watson, Douglas J / Evans, Robert / Rome, Keith / Singh, Jasvinder A. ·From the Department of Medicine, University of Otago, Wellington, New Zealand; Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA; Department of Medicine, University of Auckland, Auckland, New Zealand; University of Pennsylvania and Veterans Affairs (VA) Medical Center, Philadelphia, Pennsylvania, USA; Department of Medicine, University of Florida, Gainesville, Florida, USA; SDG LLC, Cambridge, Massachusetts, USA; and Integrated Hospital Care Franchise, Immunology, Novartis Pharma AG, Basel, Switzerland; Pfizer Inc., New York, New York, USA; Epidemiology, Merck Sharp & Dohme Corp., Whitehouse Station, New Jersey, USA; Clinical Sciences, Regeneron Pharmaceuticals, Tarrytown, New Jersey, USA; Health & Rehabilitation Research Institute and School of Podiatry, Auckland University of Technology, Auckland, New Zealand; and Birmingham VA Medical Center and University of Alabama at Birmingham, Birmingham, Alabama, USA. ·J Rheumatol · Pubmed #24429178.

ABSTRACT: OBJECTIVE: To determine the extent to which instruments that measure core outcome domains in acute gout fulfill the Outcome Measures in Rheumatology (OMERACT) filter requirements of truth, discrimination, and feasibility. METHODS: Patient-level data from 4 randomized controlled trials of agents designed to treat acute gout and 1 observational study of acute gout were analyzed. For each available measure, construct validity, test-retest reliability, within-group change using effect size, between-group change using the Kruskall-Wallis statistic, and repeated measures generalized estimating equations were assessed. Floor and ceiling effects were also assessed and minimal clinically important difference was estimated. These analyses were presented to participants at OMERACT 11 to help inform voting for possible endorsement. RESULTS: There was evidence for construct validity and discriminative ability for 3 measures of pain [0 to 4 Likert, 0 to 10 numeric rating scale (NRS), 0 to 100 mm visual analog scale (VAS)]. Likewise, there appears to be sufficient evidence for a 4-point Likert scale to possess construct validity and discriminative ability for physician assessment of joint swelling and joint tenderness. There was some evidence for construct validity and within-group discriminative ability for the Health Assessment Questionnaire as a measure of activity limitations, but not for discrimination between groups allocated to different treatment. CONCLUSION: There is sufficient evidence to support measures of pain (using Likert, NRS, or VAS), joint tenderness, and swelling (using Likert scale) as fulfilling the requirements of the OMERACT filter. Further research on a measure of activity limitations in acute gout clinical trials is required.

19 Article Synovial fluid metabolomics in different forms of arthritis assessed by nuclear magnetic resonance spectroscopy. 2012

Hügle, Thomas / Kovacs, Helena / Heijnen, Ingmar A F M / Daikeler, Thomas / Baisch, Ulrich / Hicks, Joshua M / Valderrabano, Victor. ·Department of Rheumatology, University Hospital Basel, Switzerland. thomas.huegle@unibas.ch ·Clin Exp Rheumatol · Pubmed #22410098.

ABSTRACT: OBJECTIVES: Currently there are no reliable biomarkers in the synovial fluid available to differentiate between septic and non-septic arthritis or to predict the prognosis of osteoarthritis, respectively. Nuclear magnetic resonance (NMR) spectroscopy is an analytical technique that allows a rapid, high throughput metabolic profiling of biological fluids or tissues. METHODS: Proton (1H)-nuclear magnetic resonance (NMR) spectroscopy was performed in synovial fluid samples from patients with septic arthritis, crystal arthropathy, different forms of inflammatory arthritis or osteoarthritis (OA). The metabolic environment based on the low molecular weight components was compared in disease subsets and principal component analysis (PCA) was performed. RESULTS: Fifty-nine samples from patients with OA, gout, calcium pyrophosphate disease, spondylarthritis, septic arthritis and rheumatoid arthritis (RA) were analysed. NMR yielded stable and reproducible metabolites over time. Thirty-five different metabolites as well as paracetamol and ibuprofen were identified in synovial fluid. The metabolic profile of septic arthritis assessed by PCA was distinguishable from the other samples whereas no differences were seen in OA compared to crystal-associated arthritis, RA or spondylarthritis. CONCLUSIONS: 1H-NMR is a fast analytic tool with possible implications in synovial fluid diagnostics. A distinctive metabolism is observed in septic arthritis whereas metabolites in OA are similar to those in inflammatory arthritis.