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Gout: HELP
Articles from Boston
Based on 136 articles published since 2008
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These are the 136 published articles about Gout that originated from Boston during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6
1 Guideline Autosomal dominant tubulointerstitial kidney disease: diagnosis, classification, and management--A KDIGO consensus report. 2015

Eckardt, Kai-Uwe / Alper, Seth L / Antignac, Corinne / Bleyer, Anthony J / Chauveau, Dominique / Dahan, Karin / Deltas, Constantinos / Hosking, Andrew / Kmoch, Stanislav / Rampoldi, Luca / Wiesener, Michael / Wolf, Matthias T / Devuyst, Olivier / Anonymous4640822. ·Department of Nephrology and Hypertension, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany. · Divisions of Nephrology and Molecular and Vascular Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, USA. · INSERM U1163, Laboratory of Hereditary Kidney Diseases, Paris, France. · Paris Descartes University, Imagine Institute, Paris, France. · Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA. · Département de Néphrologie et Transplantation d'organes, CHU Rangueil, Toulouse, France. · Centre de Génétique Humaine, Institut de Pathologie et de Génétique, Gosselies, Belgium. · Department of Biological Sciences, Molecular Medicine Research Center and Laboratory of Molecular and Medical Genetics, University of Cyprus, Nicosia, Cyprus. · UKD Foundation, New York, New York, USA. · Institute for Inherited Metabolic Disorders, Charles University in Prague, Prague, Czech Republic. · Molecular Genetics of Renal Disorders Unit, Division of Genetics and Cell Biology, Dulbecco Telethon Institute c/o IRCCS San Raffaele Scientific Institute, Milan, Italy. · Division of Pediatric Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA. · Institute of Physiology, University of Zurich, Zurich, Switzerland. ·Kidney Int · Pubmed #25738250.

ABSTRACT: Rare autosomal dominant tubulointerstitial kidney disease is caused by mutations in the genes encoding uromodulin (UMOD), hepatocyte nuclear factor-1β (HNF1B), renin (REN), and mucin-1 (MUC1). Multiple names have been proposed for these disorders, including 'Medullary Cystic Kidney Disease (MCKD) type 2', 'Familial Juvenile Hyperuricemic Nephropathy (FJHN)', or 'Uromodulin-Associated Kidney Disease (UAKD)' for UMOD-related diseases and 'MCKD type 1' for the disease caused by MUC1 mutations. The multiplicity of these terms, and the fact that cysts are not pathognomonic, creates confusion. Kidney Disease: Improving Global Outcomes (KDIGO) proposes adoption of a new terminology for this group of diseases using the term 'Autosomal Dominant Tubulointerstitial Kidney Disease' (ADTKD) appended by a gene-based subclassification, and suggests diagnostic criteria. Implementation of these recommendations is anticipated to facilitate recognition and characterization of these monogenic diseases. A better understanding of these rare disorders may be relevant for the tubulointerstitial fibrosis component in many forms of chronic kidney disease.

2 Editorial Editorial: Do Not Let Gout Apathy Lead to Gouty Arthropathy. 2017

FitzGerald, John D / Neogi, Tuhina / Choi, Hyon K. ·University of California, Los Angeles. · Boston University, Boston, Massachusetts. · Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts. ·Arthritis Rheumatol · Pubmed #28002890.

ABSTRACT: -- No abstract --

3 Editorial To Treat or Not to Treat (to Target) in Gout. 2017

Neogi, Tuhina / Mikuls, Ted R. ·From Boston University School of Medicine, Boston, Massachusetts · University of Nebraska Medical Center, Omaha, Nebraska. ·Ann Intern Med · Pubmed #27802507.

ABSTRACT: -- No abstract --

4 Editorial Editorial: The Sound and the Fury: Musculoskeletal Ultrasound in the Diagnosis of Gout. 2017

Kissin, Eugene Y / Pillinger, Michael H. ·Boston University School of Medicine, Boston, Massachusetts. · New York University School of Medicine, New York, New York. ·Arthritis Rheumatol · Pubmed #27748075.

ABSTRACT: -- No abstract --

5 Editorial Editorial: The Ethics of Recent Gout Trials. 2016

Shmerling, Robert H. ·Beth Israel Deaconess Medical Center, Boston, Massachusetts; Chair, American College of Rheumatology Committee on Ethics and Conflicts of Interest. ·Arthritis Rheumatol · Pubmed #27110864.

ABSTRACT: -- No abstract --

6 Editorial Gout and crystal arthropathies. 2014

Neogi, Tuhina. ·Clinical Epidemiology Research and Training Unit, and Rheumatology, Boston University School of Medicine, 650 Albany Street, Clin Epi Unit, Suite X200, Boston, MA 02118, USA. Electronic address: tneogi@bu.edu. ·Rheum Dis Clin North Am · Pubmed #24703355.

ABSTRACT: -- No abstract --

7 Editorial Crystal deposition diseases. 2014

Choi, Hyon. ·Boston University School of Medicine, Section of Rheumatology and the Clinical Epidemiology Unit, Boston, Massachusetts, USA. ·Curr Opin Rheumatol · Pubmed #24445481.

ABSTRACT: -- No abstract --

8 Review Inflammatory arthritis and crystal arthropathy: Current concepts of skin and systemic manifestations. 2018

Fazel, Mahdieh / Merola, Joseph F / Kurtzman, Drew J B. ·Division of Dermatology, The University of Arizona College of Medicine, Tucson, Arizona, USA. · Division of Rheumatology and Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. · Division of Dermatology, The University of Arizona College of Medicine, Tucson, Arizona, USA. Electronic address: kurtzman@email.arizona.edu. ·Clin Dermatol · Pubmed #30047436.

ABSTRACT: Systemic inflammatory disorders frequently involve the skin, and when cutaneous disease develops, such dermatologic manifestations may represent the initial sign of disease and may also provide valuable prognostic information about the underlying disorder. Familiarity with the various skin manifestations of systemic disease is therefore paramount and increases the likelihood of accurate diagnosis, which may facilitate the implementation of an appropriate treatment strategy. An improvement in quality of life and a reduction in the degree of morbidity may also be a realized benefit of accurate recognition of these skin signs. With this context in mind, this review highlights the salient clinical features and unique dermatologic manifestations of rheumatoid arthritis, adult-onset Still's disease, and the crystal arthropathy, gout.

9 Review Lesinurad (Zurampic) for Gout. 2018

On, Phung C. ·Massachusetts College of Pharmacy and Health Sciences University, Boston, MA, USA. ·Am Fam Physician · Pubmed #29671542.

ABSTRACT: -- No abstract --

10 Review Nonrheumatoid Arthritis of the Hand. 2018

Lans, Jonathan / Machol, Jacques A / Deml, Christian / Chen, Neal C / Jupiter, Jesse B. ·Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: jlans@mgh.harvard.edu. · Department of Orthopedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA. · Department of Trauma Surgery, Division of Hand and Wrist Surgery, Medical University of Innsbruck, Austria. ·J Hand Surg Am · Pubmed #29132785.

ABSTRACT: Arthropathy of the hand is commonly encountered. Contributing factors such as aging, trauma, and systemic illness all may have a role in the evolution of this pathology. Besides rheumatoid arthritis, other diseases affect the small joints of the hand. A review of nonrheumatoid hand arthropathies is beneficial for clinicians to recognize these problems.

11 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.

12 Review Serum Uric Acid and the Risk of Incident and Recurrent Gout: A Systematic Review. 2017

Shiozawa, Aki / Szabo, Shelagh M / Bolzani, Anna / Cheung, Antoinette / Choi, Hyon K. ·From Takeda Pharmaceuticals International Inc., Deerfield, Illinois; Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Redwood Outcomes, Vancouver, British Columbia, Canada. · A. Shiozawa, Associate Director, MPH, Takeda Pharmaceuticals International Inc.; S.M. Szabo, Principal, MSc, Redwood Outcomes; A. Bolzani, Research Associate, MSc, Redwood Outcomes; A. Cheung, Research Associate, MPH, Redwood Outcomes; H.K. Choi, Professor, Director, MD, DrPH, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School. · From Takeda Pharmaceuticals International Inc., Deerfield, Illinois; Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA; Redwood Outcomes, Vancouver, British Columbia, Canada. sszabo@broadstreetheor.com. · A. Shiozawa, Associate Director, MPH, Takeda Pharmaceuticals International Inc.; S.M. Szabo, Principal, MSc, Redwood Outcomes; A. Bolzani, Research Associate, MSc, Redwood Outcomes; A. Cheung, Research Associate, MPH, Redwood Outcomes; H.K. Choi, Professor, Director, MD, DrPH, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School. sszabo@broadstreetheor.com. ·J Rheumatol · Pubmed #28148699.

ABSTRACT: OBJECTIVE: Lowering serum uric acid (SUA) levels can essentially cure gout; however, this is not widely practiced. To summarize epidemiologic evidence related to this causal link, we conducted a systematic review of the published literature reporting the association between SUA level and incident and recurrent gout (i.e., gout flares). METHODS: We systematically searched Medline, EMBASE, and the Cochrane Database of Systematic Reviews using separate search strategies for incident gout and recurrent gout. We screened 646 abstracts to identify 8 eligible articles reporting gout incidence and 913 abstracts to identify 18 articles reporting recurrent gout. RESULTS: For both gout incidence and recurrence, a graded trend was observed where the risk was increased with higher SUA levels. Gout incidence rates per 1000 person-years from population-based studies ranged from 0.8 (SUA ≤ 6 mg/dl) to 70.2 cases (SUA ≥ 10 mg/dl). Recurrent gout risk in clinical cohorts ranged from 12% (SUA ≤ 6 mg/dl) to 61% (SUA ≥ 9 mg/dl) among those receiving urate-lowering therapy (ULT), and 3.7% (SUA 6-7 mg/dl) to 61% (SUA > 9.3 mg/dl) after successful ULT. Retrospective database studies also showed a graded relationship, although the strength of the association was weaker. Studies reporting mean flares or time-to-flare according to SUA showed similar findings. CONCLUSION: This systematic review confirms that higher SUA levels are associated with increased risk of incident and recurrent gout in a graded manner. Although few prospective cohorts have evaluated incident and recurrent gout according to SUA, the existing evidence underscores the need to treat to SUA targets, as recommended by the American College of Rheumatology and the European League Against Rheumatism.

13 Review Review: Gout: A Roadmap to Approaches for Improving Global Outcomes. 2017

Dalbeth, Nicola / Choi, Hyon K / Terkeltaub, Robert. ·University of Auckland, Auckland, New Zealand. · Massachusetts General Hospital and Harvard Medical School, Boston. · VA San Diego Healthcare System and University of California, San Diego. ·Arthritis Rheumatol · Pubmed #27389665.

ABSTRACT: -- No abstract --

14 Review Gout Classification Criteria: Update and Implications. 2016

Vargas-Santos, Ana Beatriz / Taylor, William J / Neogi, Tuhina. ·Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, X building, Suite 200, 650 Albany Street, Boston, MA, 02118, USA. · Department of Medicine, University of Otago Wellington, PO Box 7343, Wellington, New Zealand. · Clinical Epidemiology Research and Training Unit, Boston University School of Medicine, X building, Suite 200, 650 Albany Street, Boston, MA, 02118, USA. tneogi@bu.edu. ·Curr Rheumatol Rep · Pubmed #27342957.

ABSTRACT: Gout is the most common inflammatory arthritis, with a rising prevalence and incidence worldwide. There has been a resurgence in gout research, fueled, in part, by a number of advances in pharmacologic therapy for gout. The conduct of clinical trials and other observational research in gout requires a standardized and validated means of assembling well-defined groups of patients with gout for such research purposes. Recently, an international collaborative effort that involved a data-driven process with state-of-the art methodology supported by the American College of Rheumatology and the European League Against Rheumatism led to publication of new gout classification criteria.

15 Review Treatment of tophaceous gout: When medication is not enough. 2016

Kasper, Isaac R / Juriga, Matthew D / Giurini, John M / Shmerling, Robert H. ·Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. Electronic address: ikasper@bidmc.harvard.edu. · Department of Surgery, Beth Israel Deaconess Medical Center, Boston, MA. · Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, Boston, MA 02215. ·Semin Arthritis Rheum · Pubmed #26947439.

ABSTRACT: OBJECTIVES: To review the literature concerning surgical intervention of tophaeceous gout and propose clinical circumstances for when it may be considered. INTRODUCTION: Tophi develop in approximately 12-35% of patients with gout. Tophaceous disease is usually preventable given the availability of effective urate lowering therapies (ULT) including allopurinol, febuxostat, probenecid, lesinurad, and pegloticase. Despite medical therapy, there remains a subset of patients who develop significant complications of tophi including infection, ulceration, and entrapment neuropathy. Tophi in close proximity to joints can cause joint instability, severely limited range of motion, and significant functional impairment. For the rare circumstance when a tophus is causing an urgent complication or if a patient has a contraindication to all available ULTs, surgery may be an appropriate option. This review summarizes the published experience with surgical interventions for tophaceous gout and offers recommendations for its consideration. METHODS: Using Medline and Google Scholar, all available series of surgery for tophaceous gout were reviewed. RESULTS: Overall, 7 published surgical series were identified. In all, 6 of these 7 series were published between 2002 and 2014. The reported outcomes of surgical interventions for tophaceous gout were generally positive without major post-surgical complications. CONCLUSION: Although medical therapy with ULTs should be the first-line approach to tophaceous gout, surgery should be considered for the rare patient with impending or severe, debilitating complications including infections, entrapment neuropathy or those at risk for permanent joint destruction. In these selected clinical circumstances, surgical intervention for tophaceous gout may be appropriate.

16 Review The economic burden of gout: A systematic review. 2015

Rai, Sharan K / Burns, Lindsay C / De Vera, Mary A / Haji, Aliya / Giustini, Dean / Choi, Hyon K. ·Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Experimental Medicine, University of British Columbia, Vancouver, British Columbia, Canada. · Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Psychology, York University, Toronto, Ontario, Canada. · Arthritis Research Canada, Vancouver, British Columbia, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada. · School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. · Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. · Arthritis Research Canada, Vancouver, British Columbia, Canada; Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada; Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: Choi.Hyon@mgh.harvard.edu. ·Semin Arthritis Rheum · Pubmed #25912932.

ABSTRACT: OBJECTIVE: Gout is a painful and disabling joint disease that constitutes the most common inflammatory arthritis in the US. To clarify the economic impact of gout, we systematically reviewed the literature on the direct and indirect costs associated with this disease. METHODS: We conducted a literature search of MEDLINE, EMBASE, International Pharmaceutical Abstracts, NHS Economic Evaluation, and CINAHL databases to identify studies of gout and economics. We systematically reviewed published studies that met our inclusion criteria and extracted and summarized all relevant economic parameters. Reported costs were inflation-adjusted to 2013 US dollars (USD). RESULTS: A total of 15 studies met all eligibility criteria. Three controlled studies reported all-cause total direct costs based on specific populations (i.e., $4733, $16,925, and $18,362 per capita among employed, elderly, and treatment-refractory gout populations, respectively, and $2562, $10,590, and $7188 among corresponding non-gout patients). Two additional studies, although uncontrolled, allowed for estimation of total all-cause direct costs in unselected gout populations ($11,080 and $13,170). Gout-related costs ranged from $172 to $6179, depending on population characteristics. Six studies reported positive associations of direct costs with SUA level, gout attack frequency, or presence of tophi. Four studies reported on indirect costs, which were estimated to be as high as $4341 USD. CONCLUSION: The available data suggest that gout patients incur substantially greater direct and indirect costs as compared with gout-free individuals among elderly and treatment-refractory gouty patients, whereas the costs are considerably less among younger, employed gouty patients. Further, direct costs increased with worsening disease characteristics.

17 Review Imaging as an Outcome Measure in Gout Studies: Report from the OMERACT Gout Working Group. 2015

Grainger, Rebecca / Dalbeth, Nicola / Keen, Helen / Durcan, Laura / Lawrence Edwards, N / Perez-Ruiz, Fernando / Diaz-Torne, Cesar / Singh, Jasvinder A / Khanna, Dinesh / Simon, Lee S / Taylor, William J. ·From the Department of Medicine, University of Otago Wellington, Wellington; Department of Medicine, University of Auckland, New Zealand; Mater Misericordiae University Hospital, Dublin, Ireland; School of Medicine and Pharmacology, University of Western Australia, Perth, Australia; Department of Medicine, University of Florida, Gainesville, Florida, USA; Rheumatology Division, Hospital Universitario Cruces and BioCruces Health Research Institute, Vizcaya; Division of Rheumatology, Hospital de la Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham, Birmingham, Alabama; Division of Rheumatology, Department of Medicine, University of Michigan, Ann Arbor, Michigan; SDG LLC, Cambridge, Massachusetts, USA.R. Grainger, PhD, FRACP, Senior Lecturer, Rheumatologist, Department of Medicine, University of Otago Wellington; N. Dalbeth, MD, FRACP, Associate Professor, Department of Medicine, University of Auckland; L. Durcan, Rheumatology Fellow, MD, Mater Misericordiae University Hospital; H. Keen, PhD, Associate Professor, School of Medicine and Pharmacology, University of Western Australia; N.L. Edwards, MD, Professor of Medicine, Department of Medicine, University of Florida; F. Perez-Ruiz, MD, Professor, Rheumatology Division, Hospital Universitario Cruces and BioCruces Health Research Institute; C. Diaz-Torne, PhD, Associate Professor and Rheumatologist; J.A. Singh, MBBS, MPH, Associate Professor of Medicine; Birmingham Veterans Affairs Medical Center and University of Alabama at Birmingham; D. Khanna, MD, MSc, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine, University of Michigan; L.S. Simon, MD, Principal Advisor, SDG LLC; W.J. Taylor, PhD, FRACP, Associate Professor and Rheumatologist, Department of Medicine, University of Otago Wellington. ·J Rheumatol · Pubmed #25641895.

ABSTRACT: OBJECTIVE: The gout working group at the Outcome Measures in Rheumatology (OMERACT) 12 meeting in 2014 aimed to determine which imaging modalities show the most promise for use as measurement instruments for outcomes in studies of people with chronic gout and to identify the key foci for future research about the performance of these imaging techniques with respect to the OMERACT filter 2.0. METHODS: During the gout session, a systematic literature review of the data addressing imaging modalities including plain radiography (XR), conventional computed tomography (CT), dual-energy computed tomography (DECT), magnetic resonance imaging (MRI), and ultrasound (US) and the fulfillment of the OMERACT filter 2.0 was presented. RESULTS: The working group identified 3 relevant domains for imaging in gout studies: urate deposition (tophus burden), joint inflammation, and structural joint damage. CONCLUSION: The working group prioritized gaps in the data and identified a research agenda.

18 Review Cardiovascular disease in patients with chronic inflammation: mechanisms underlying premature cardiovascular events in rheumatologic conditions. 2015

Mason, Justin C / Libby, Peter. ·Vascular Sciences Unit and Rheumatology Section, Imperial Centre for Translational and Experimental Medicine, National Heart and Lung Institute, Imperial College London, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK justin.mason@imperial.ac.uk. · Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. ·Eur Heart J · Pubmed #25433021.

ABSTRACT: A variety of systemic inflammatory rheumatic diseases associate with an increased risk of atherosclerotic events and premature cardiovascular (CV) disease. Although this recognition has stimulated intense basic science and clinical research, the precise nature of the relationship between local and systemic inflammation, their interactions with traditional CV risk factors, and their role in accelerating atherogenesis remains unresolved. The individual rheumatic diseases have both shared and unique attributes that might impact CV events. Understanding of the positive and negative influences of individual anti-inflammatory therapies remains rudimentary. Clinicians need to adopt an evidence-based approach to develop diagnostic techniques to identify those rheumatologic patients most at risk of CV disease and to develop effective treatment protocols. Development of optimal preventative and disease-modifying approaches for atherosclerosis in these patients will require close collaboration between basic scientists, CV specialists, and rheumatologists. This interface presents a complex, important, and exciting challenge.

19 Review Imaging modalities for the classification of gout: systematic literature review and meta-analysis. 2015

Ogdie, Alexis / Taylor, William J / Weatherall, Mark / Fransen, Jaap / Jansen, Tim L / Neogi, Tuhina / Schumacher, H Ralph / Dalbeth, Nicola. ·Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. · Department of Medicine, University of Otago, Wellington, New Zealand. · Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands. · Sections of Epidemiology and Rheumatology, Boston University School of Medicine, Boston, Massachusetts, USA. · Department of Medicine, University of Auckland, Auckland, New Zealand. ·Ann Rheum Dis · Pubmed #24915980.

ABSTRACT: BACKGROUND: Although there has been major progress in gout imaging, no gout classification criteria currently include advanced imaging techniques. OBJECTIVE: To examine the usefulness of imaging modalities in the classification of gout when compared to monosodium urate (MSU) crystal confirmation as the gold standard, in order to inform development of new gout classification criteria. METHODS: We systematically reviewed the published literature concerning the diagnostic performance of plain film radiography, MRI, ultrasound (US), conventional CT and dual energy CT (DECT). Only studies with MSU crystal confirmation as the gold standard were included. When more than one study examined the same imaging feature, the data were pooled and summary test characteristics were calculated. RESULTS: 11 studies (9 manuscripts and 2 meeting abstracts) satisfied the inclusion criteria. All were set in secondary care, with mean gout disease duration of at least 7 years. Three features were examined in more than one study: the double contour sign (DCS) on US, tophus on US, and MSU crystal deposition on DECT. The pooled (95% CI) sensitivity and specificity of US DCS were 0.83 (0.72 to 0.91) and 0.76 (0.68 to 0.83), respectively; of US tophus, were 0.65 (0.34 to 0.87) and 0.80 (0.38 to 0.96), respectively; and of DECT, were 0.87 (0.79 to 0.93) and 0.84 (0.75 to 0.90), respectively. CONCLUSIONS: US and DECT show promise for gout classification but the few studies to date have mostly been in patients with longstanding, established disease. The contribution of imaging over clinical features for gout classification criteria requires further examination.

20 Review Gout: a review of nonmodifiable and modifiable risk factors. 2014

MacFarlane, Lindsey A / Kim, Seoyoung C. ·Department of Medicine, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. · Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, 1620 Tremont Street, Suite 3030, Boston, MA 02120, USA; Division of Rheumatology, Allergy and Immunology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. Electronic address: skim62@partners.org. ·Rheum Dis Clin North Am · Pubmed #25437279.

ABSTRACT: Gout is a common inflammatory arthritis triggered by the crystallization of uric acid within the joints. Gout affects millions worldwide and has an increasing prevalence. Recent research has been carried out to better qualify and quantify the risk factors predisposing individuals to gout. These can largely be broken into nonmodifiable risk factors, such as gender, age, race, and genetics, and modifiable risk factors, such as diet and lifestyle. Increasing knowledge of factors predisposing certain individuals to gout could potentially lead to improved preventive practices. This review summarizes the nonmodifiable and modifiable risk factors associated with development of gout.

21 Review Inpatient gout: a review. 2014

Fisher, Mark C / Pillinger, Michael H / Keenan, Robert T. ·Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, 2100 Yawkey 55 Fruit St., Boston, MA, 02114, USA, MFISHER6@mgh.harvard.edu. ·Curr Rheumatol Rep · Pubmed #25304216.

ABSTRACT: -- No abstract --

22 Review The genetic basis of gout. 2014

Merriman, Tony R / Choi, Hyon K / Dalbeth, Nicola. ·Department of Biochemistry, University of Otago, Dunedin 9012, New Zealand. Electronic address: tony.merriman@otago.ac.nz. · Section of Rheumatology and Clinical Epidemiology Unit, Boston University School of Medicine, Boston, MA 02118, USA. · Department of Medicine, University of Auckland, Auckland 1023, New Zealand. ·Rheum Dis Clin North Am · Pubmed #24703347.

ABSTRACT: Gout results from deposition of monosodium urate (MSU) crystals. Elevated serum urate concentrations (hyperuricemia) are not sufficient for the development of disease. Genome-wide association studies (GWAS) have identified 28 loci controlling serum urate levels. The largest genetic effects are seen in genes involved in the renal excretion of uric acid, with others being involved in glycolysis. Whereas much is understood about the genetic control of serum urate levels, little is known about the genetic control of inflammatory responses to MSU crystals. Extending knowledge in this area depends on recruitment of large, clinically ascertained gout sample sets suitable for GWAS.

23 Review Epidemiology of gout. 2014

Roddy, Edward / Choi, Hyon K. ·Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK. Electronic address: e.roddy@keele.ac.uk. · Section of Rheumatology and Clinical Epidemiology Unit, Boston University School of Medicine, 650 Albany Street, Suite 200, Boston, MA 02118, USA. ·Rheum Dis Clin North Am · Pubmed #24703341.

ABSTRACT: Gout is the most prevalent inflammatory arthritis in men. The findings of several epidemiologic studies from a diverse range of countries suggest that the prevalence of gout has risen over the past few decades. Although incidence data are scarce, data from the United States suggests that the incidence of gout is also rising. Evidence from prospective epidemiologic studies has confirmed dietary factors (animal purines, alcohol, and fructose), obesity, the metabolic syndrome, hypertension, diuretic use, and chronic kidney disease as clinically relevant risk factors for hyperuricemia and gout. Low-fat dairy products, coffee, and vitamin C seem to have a protective effect.

24 Review The kidney in hyperuricemia and gout. 2013

Mount, David B. ·Renal Divisions, Brigham and Women's Hospital, VA Boston Healthcare System, Boston, Massachusetts, USA. david.mount2@va.gov ·Curr Opin Nephrol Hypertens · Pubmed #23318701.

ABSTRACT: PURPOSE OF REVIEW: Gout is a painful inflammatory arthritis associated with hyperuricemia, with a prevalence of almost 10 million in the USA. Reduced renal excretion of urate is the underlying hyperuricemic mechanism in the vast majority of gout patients; most of the genes that affect serum urate level (SUA) encode urate transporters or associated regulatory proteins. Acquired influences can also modulate SUA and renal urate excretion, sometimes precipitating acute gout. Coincidentally, the prevalence of renal comorbidities in gout - hypertension, chronic kidney disease (CKD), and nephrolithiasis - is very high. RECENT FINDINGS: Recent advances in genetics and molecular physiology have greatly enhanced the understanding of renal reabsorption and secretion of filtered urate. Moreover, baseline SUA appears to be set by the net balance of absorption and secretion across epithelial cells in the kidney and intestine. There have also been substantial advances in the management of gout in patients with CKD. SUMMARY: The stage is set for an increasingly molecular understanding of baseline and regulated urate transport by the kidney and intestine. The increasing prevalence of gout with CKD will be balanced by an expanding spectrum of therapeutic options for this important disease.

25 Review The epidemiology of uric acid and fructose. 2011

Rho, Young Hee / Zhu, Yanyan / Choi, Hyon K. ·Section of Rheumatology, Boston University School of Medicine, Boston, MA 02118, USA. ·Semin Nephrol · Pubmed #22000647.

ABSTRACT: During the past few decades, the mean serum uric acid levels and the prevalence of hyperuricemia in the general population appear to have increased. Correspondingly, the prevalence and incidence of gout have doubled. Potential reasons behind these trends include the increasing prevalence of obesity and metabolic syndrome, Western lifestyle factors, increased prevalence of medical conditions (eg, renal conditions, hypertension, and cardiovascular disorders), and use of medications that increase uric acid levels (eg, diuretics and low-dose aspirin). The substantial increase in sugar-sweetened soft drinks and associated fructose consumption also has coincided with the secular trend of hyperuricemia and gout. Recently, several large-scale epidemiologic studies have clarified a number of these long-suspected risk factors in relation with hyperuricemia and gout. Furthermore, recent studies have illuminated the substantial comorbidities of hyperuricemia and gout, particularly metabolic-cardiovascular-renal conditions. Although many prospective studies have suggested an independent association between serum uric acid levels and the future risk of cardiovascular-metabolic morbidities and mortality, only a limited number of randomized clinical trials and observational studies recently have shown that the use of allopurinol can be beneficial against these outcomes. Because these data are scarce and the effects of allopurinol might not be limited to decreasing serum uric acid levels, the potential causal role of uric acid on these outcomes remains to be clarified with further studies.

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