Pick Topic
Review Topic
List Experts
Examine Expert
Save Expert
  Site Guide ··   
Gout: HELP
Articles from Miscellaneous cities in Maryland
Based on 7 articles published since 2010
||||

These are the 7 published articles about Gout that originated from Miscellaneous cities in Maryland during 2010-2020.
 
+ Citations + Abstracts
1 Review Current and future therapeutic options for the management of gout. 2010

Whelton, Andrew. ·Universal Clinical Research Center, Inc., Hunt Valley, MD, USA. huntvalley@aol.com ·Am J Ther · Pubmed #20562597.

ABSTRACT: The incidence of gout and the clinical manifestation of hyperuricemia continue to rise. In addition to painful acute attacks, chronic gout can lead to the development of crystal arthropathy, tophi, and renal lithiasis, coincidental with declines in quality of life. As a greater appreciation for the associations between hyperuricemia, gout, and certain comorbidities, such as renal impairment and cardiovascular diseases, grows, so does the search for new therapeutic options to both alleviate the painful symptoms of acute gout attacks and reduce the underlying hyperuricemia. This manuscript reviews the pathophysiology of hyperuricemia and gout, and associated comorbidities, and then discusses traditional therapeutic options, newly available agents, and future targets for pharmacologic management.

2 Clinical Trial The Pharmacodynamics, Pharmacokinetics, and Safety of Arhalofenate in Combination with Febuxostat When Treating Hyperuricemia Associated with Gout. 2017

Steinberg, Alexandra S / Vince, Bradley D / Choi, Yun-Jung / Martin, Robert L / McWherter, Charles A / Boudes, Pol F. ·From CymaBay Therapeutics Inc., Newark, California; Vince and Associates, Overland Park, Kansas, USA. · A.S. Steinberg, MD, PhD, CymaBay Therapeutics Inc.; B.D. Vince, DO, Vince and Associates; Y.J. Choi, PhD, CymaBay Therapeutics Inc.; R.L. Martin, PhD, CymaBay Therapeutics Inc.; C.A. McWherter, PhD, CymaBay Therapeutics Inc.; P.F. Boudes, MD, CymaBay Therapeutics Inc. · From CymaBay Therapeutics Inc., Newark, California; Vince and Associates, Overland Park, Kansas, USA. pboudes@cymabay.com. · A.S. Steinberg, MD, PhD, CymaBay Therapeutics Inc.; B.D. Vince, DO, Vince and Associates; Y.J. Choi, PhD, CymaBay Therapeutics Inc.; R.L. Martin, PhD, CymaBay Therapeutics Inc.; C.A. McWherter, PhD, CymaBay Therapeutics Inc.; P.F. Boudes, MD, CymaBay Therapeutics Inc. pboudes@cymabay.com. ·J Rheumatol · Pubmed #27980008.

ABSTRACT: OBJECTIVE: Arhalofenate (ARH), in development for gout, has uricosuric and anti-flare activities. ARH plus febuxostat (FBX) were evaluated in subjects with gout for serum uric acid (SUA) lowering, drug interaction, and safety. METHODS: Open phase II trial in gout volunteers (NCT02252835). Cohort 1 received ARH 600 mg for 2 weeks, followed by sequential 1-week co-administration of FBX 80 mg followed by 40 mg. FBX 40 mg was continued alone for 2 weeks. Cohort 2 received ARH 800 mg for 2 weeks, followed by sequential 1-week co-administration of FBX 40 mg followed by 80 mg. FBX 80 mg was continued alone for 2 weeks. SUA, its fractional excretion (FEUA), and plasma oxypurines were assessed. Pharmacokinetics of FBX and ARH were determined alone and in combination for cohort 2. RESULTS: Baseline mean SUA was 9.4 mg/dl for cohort 1 (n = 16) and 9.2 mg/dl for cohort 2 (n = 16). The largest SUA decrease (63%) was observed with ARH 800 mg + FBX 80 mg, with all subjects reaching SUA < 6 mg/dl and 93% < 5 mg/dl. The area under the curve (AUC) CONCLUSION: ARH and FBX lowered SUA by complementary mechanisms. The combination provided greater decreases than each drug alone. The combination was well tolerated and appeared safe. TRIAL REGISTRATION: NCT02252835.

3 Clinical Trial Preservation of renal function during gout treatment with febuxostat: a quantitative study. 2013

Whelton, Andrew / MacDonald, Patricia A / Chefo, Solomon / Gunawardhana, Lhanoo. ·Universal Clinical Research Center, Inc, Hunt Valley, MD, USA. huntvalley@aol.com ·Postgrad Med · Pubmed #23391676.

ABSTRACT: BACKGROUND: Hyperuricemia can accelerate renal decline associated with aging. Chronic kidney disease is frequently seen in patients with hyperuricemia and gout. OBJECTIVES: Assess the impact of urate-lowering therapy on renal function in subjects with gout who were treated with febuxostat for ≤ 48 months. METHODS: Subjects from 2 phase 3 clinical studies were enrolled in the phase 3, long-term, open-label Febuxostat/Allopurinol Comparative Extension Long-Term (EXCEL) study. In the EXCEL study, 1086 subjects initially were treated with febuxostat 80 or 120 mg daily, or allopurinol 300 mg daily. The subjects were permitted to switch between doses of febuxostat and/or allopurinol during the first 6 months of treatment to achieve and maintain a serum uric acid (SUA) level ≥ 3 to < 6 mg/dL. For the analysis presented in this article, data from 551 subjects who received only febuxostat throughout the duration of both the phase 3 and EXCEL studies (≤ 48 months) were used to determine the impact of SUA reduction on estimated glomerular filtration rates (eGFRs). RESULTS: At baseline of the 2 original phase 3 studies, subjects' mean SUA level was 9.8 mg/dL. Greater sustained decreases in subjects' SUA levels were associated with less renal function decline (P < 0.001) by statistical modeling. The study data predicted that for every 1 mg/dL of chronic reduction of SUA level in subjects with gout, there would be a preservation of 1.15 mL/min of eGFR. CONCLUSION: Sustained urate-lowering therapy with febuxostat appears to impede renal decline in patients with gout. The results discussed in this article support similar observations previously reported in 116 hyperuricemic subjects with gout who received febuxostat for ≤ 5 years.

4 Clinical Trial Renal function in gout: long-term treatment effects of febuxostat. 2011

Whelton, Andrew / Macdonald, Patricia A / Zhao, Lin / Hunt, Barbara / Gunawardhana, Lhanoo. ·Universal Clinical Research Center, Inc., 1737 Beaver Brook Lane, Hunt Valley, MD 21030-1603, USA. huntvalley@aol.com ·J Clin Rheumatol · Pubmed #21169856.

ABSTRACT: BACKGROUND: The association between hyperuricemia, gout, and impaired renal function has long been recognized. Recent data provide evidence for the causal relationship between elevated serum urate (sUA) and renal changes, leading to declines in glomerular filtration rates. In healthy adults, glomerular filtration rate wanes with age. Urate-lowering therapy (ULT) with allopurinol has been shown to stabilize or reverse this. OBJECTIVE: Here we examine the long-term effects of ULT with febuxostat on estimated glomerular filtration rate (eGFR). METHODS: This is a post hoc analysis of the Febuxostat Open-label Clinical trial of Urate-lowering efficacy and Safety study, during which 116 hyperuricemic gout subjects received daily doses of febuxostat (40, 80, or 120 mg) for up to 5 years. sUA concentrations and eGFR were assessed regularly. Results were stratified by mean change in sUA from baseline. Mathematical modeling was used to predict the effect of sUA reduction on eGFR. RESULTS: Maintenance or improvement in eGFR was inversely correlated with the quantitative reduction in sUA from baseline. For every 1 mg/dL decrease in sUA, the model projected an expected improvement in eGFR of 1 mL/min from the untreated value. CONCLUSION: Individuals with the greatest reductions in sUA may experience reduced rates of renal deterioration or even stabilization of renal function. Further studies examining the impact of long-term ULT on renal function in hyperuricemic gout patients are needed to both confirm our results and verify if improvements in renal function are feasible in such patients.

5 Article Are Target Urate and Remission Possible in Severe Gout? A Five-year Cohort Study. 2020

Alvarado-de la Barrera, Claudia / López-López, Carlos Omar / Álvarez-Hernández, Everardo / Peláez-Ballestas, Ingris / Gómez-Ruiz, Citlallyc / Burgos-Vargas, Rubén / Vázquez-Mellado, Janitzia. ·From the Dirección de Investigación, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Servicio de Medicina Física y Rehabilitación, Unidad 402, Hospital General de México; Servicio de Reumatología, Unidad 404, Hospital General de México, Mexico City, Mexico. · C. Alvarado-de la Barrera, PhD, Dirección de Investigación, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; C.O. López-López, MD, PhD, Servicio de Medicina Física y Rehabilitación, Unidad 402, Hospital General de México; E. Álvarez-Hernández, MD, Servicio de Reumatología, Unidad 404, Hospital General de México; I. Peláez-Ballestas, MD, PhD, Servicio de Reumatología, Unidad 404, Hospital General de México; C. Gómez-Ruiz, MD, Servicio de Reumatología, Unidad 404, Hospital General de México; R. Burgos-Vargas, MD, Servicio de Medicina Física y Rehabilitación, Unidad 402, and Servicio de Reumatología, Unidad 404, Hospital General de México; J. Vázquez-Mellado, MD, PhD, Servicio de Reumatología, Unidad 404, Hospital General de México. · From the Dirección de Investigación, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; Servicio de Medicina Física y Rehabilitación, Unidad 402, Hospital General de México; Servicio de Reumatología, Unidad 404, Hospital General de México, Mexico City, Mexico. jvazquezmellado@prodigy.net.mx. · C. Alvarado-de la Barrera, PhD, Dirección de Investigación, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas; C.O. López-López, MD, PhD, Servicio de Medicina Física y Rehabilitación, Unidad 402, Hospital General de México; E. Álvarez-Hernández, MD, Servicio de Reumatología, Unidad 404, Hospital General de México; I. Peláez-Ballestas, MD, PhD, Servicio de Reumatología, Unidad 404, Hospital General de México; C. Gómez-Ruiz, MD, Servicio de Reumatología, Unidad 404, Hospital General de México; R. Burgos-Vargas, MD, Servicio de Medicina Física y Rehabilitación, Unidad 402, and Servicio de Reumatología, Unidad 404, Hospital General de México; J. Vázquez-Mellado, MD, PhD, Servicio de Reumatología, Unidad 404, Hospital General de México. jvazquezmellado@prodigy.net.mx. ·J Rheumatol · Pubmed #31043541.

ABSTRACT: OBJECTIVE: Determine the proportion of patients achieving target serum urate (SU), defined as < 6 mg/dl for patients with non-severe gout and < 5 mg/dl for patients with severe gout, as well as the proportion of patients achieving remission after 5 years of followup. METHODS: Patients from the Gout Study Group (GRESGO) cohort were evaluated at 6-month intervals. Demographic and clinical data were obtained at baseline. Visits included assessments of serum urate, flares, tophus burden, health-related quality of life using the EQ-5D, activity limitations using the Health Assessment Questionnaire adapted for gout, and pain level and patient's global assessment using visual analog scales. Treatment for gout and associated diseases was prescribed according to guidelines and available drugs. RESULTS: Of 500 patients studied, 221 had severe gout (44%) and 279 had non-severe gout (56%) at baseline. No significant differences were observed across the study in percentages of severe gout versus non-severe gout patients achieving SU 6 mg/dl or 5 mg/dl. The highest proportion of patients achieving target SU (50-70%) and remission (39%) were found after 3-4 years of followup. In the fifth year, these proportions decreased and 28% of the patients were in remission, but only 40 patients remained in the study. None of the patients with severe gout achieved remission. CONCLUSION: In patients with severe gout, target SU was hard to achieve and remission was not possible. The main obstacles for target SU and gout remission include poor medication adherence, persistent tophi, and loss to followup.

6 Article Target genes, variants, tissues and transcriptional pathways influencing human serum urate levels. 2019

Tin, Adrienne / Marten, Jonathan / Halperin Kuhns, Victoria L / Li, Yong / Wuttke, Matthias / Kirsten, Holger / Sieber, Karsten B / Qiu, Chengxiang / Gorski, Mathias / Yu, Zhi / Giri, Ayush / Sveinbjornsson, Gardar / Li, Man / Chu, Audrey Y / Hoppmann, Anselm / O'Connor, Luke J / Prins, Bram / Nutile, Teresa / Noce, Damia / Akiyama, Masato / Cocca, Massimiliano / Ghasemi, Sahar / van der Most, Peter J / Horn, Katrin / Xu, Yizhe / Fuchsberger, Christian / Sedaghat, Sanaz / Afaq, Saima / Amin, Najaf / Ärnlöv, Johan / Bakker, Stephan J L / Bansal, Nisha / Baptista, Daniela / Bergmann, Sven / Biggs, Mary L / Biino, Ginevra / Boerwinkle, Eric / Bottinger, Erwin P / Boutin, Thibaud S / Brumat, Marco / Burkhardt, Ralph / Campana, Eric / Campbell, Archie / Campbell, Harry / Carroll, Robert J / Catamo, Eulalia / Chambers, John C / Ciullo, Marina / Concas, Maria Pina / Coresh, Josef / Corre, Tanguy / Cusi, Daniele / Felicita, Sala Cinzia / de Borst, Martin H / De Grandi, Alessandro / de Mutsert, Renée / de Vries, Aiko P J / Delgado, Graciela / Demirkan, Ayşe / Devuyst, Olivier / Dittrich, Katalin / Eckardt, Kai-Uwe / Ehret, Georg / Endlich, Karlhans / Evans, Michele K / Gansevoort, Ron T / Gasparini, Paolo / Giedraitis, Vilmantas / Gieger, Christian / Girotto, Giorgia / Gögele, Martin / Gordon, Scott D / Gudbjartsson, Daniel F / Gudnason, Vilmundur / Anonymous3221150 / Haller, Toomas / Hamet, Pavel / Harris, Tamara B / Hayward, Caroline / Hicks, Andrew A / Hofer, Edith / Holm, Hilma / Huang, Wei / Hutri-Kähönen, Nina / Hwang, Shih-Jen / Ikram, M Arfan / Lewis, Raychel M / Ingelsson, Erik / Jakobsdottir, Johanna / Jonsdottir, Ingileif / Jonsson, Helgi / Joshi, Peter K / Josyula, Navya Shilpa / Jung, Bettina / Kähönen, Mika / Kamatani, Yoichiro / Kanai, Masahiro / Kerr, Shona M / Kiess, Wieland / Kleber, Marcus E / Koenig, Wolfgang / Kooner, Jaspal S / Körner, Antje / Kovacs, Peter / Krämer, Bernhard K / Kronenberg, Florian / Kubo, Michiaki / Kühnel, Brigitte / La Bianca, Martina / Lange, Leslie A / Lehne, Benjamin / Lehtimäki, Terho / Anonymous3231150 / Liu, Jun / Loeffler, Markus / Loos, Ruth J F / Lyytikäinen, Leo-Pekka / Magi, Reedik / Mahajan, Anubha / Martin, Nicholas G / März, Winfried / Mascalzoni, Deborah / Matsuda, Koichi / Meisinger, Christa / Meitinger, Thomas / Metspalu, Andres / Milaneschi, Yuri / Anonymous3241150 / O'Donnell, Christopher J / Wilson, Otis D / Gaziano, J Michael / Mishra, Pashupati P / Mohlke, Karen L / Mononen, Nina / Montgomery, Grant W / Mook-Kanamori, Dennis O / Müller-Nurasyid, Martina / Nadkarni, Girish N / Nalls, Mike A / Nauck, Matthias / Nikus, Kjell / Ning, Boting / Nolte, Ilja M / Noordam, Raymond / O'Connell, Jeffrey R / Olafsson, Isleifur / Padmanabhan, Sandosh / Penninx, Brenda W J H / Perls, Thomas / Peters, Annette / Pirastu, Mario / Pirastu, Nicola / Pistis, Giorgio / Polasek, Ozren / Ponte, Belen / Porteous, David J / Poulain, Tanja / Preuss, Michael H / Rabelink, Ton J / Raffield, Laura M / Raitakari, Olli T / Rettig, Rainer / Rheinberger, Myriam / Rice, Kenneth M / Rizzi, Federica / Robino, Antonietta / Rudan, Igor / Krajcoviechova, Alena / Cifkova, Renata / Rueedi, Rico / Ruggiero, Daniela / Ryan, Kathleen A / Saba, Yasaman / Salvi, Erika / Schmidt, Helena / Schmidt, Reinhold / Shaffer, Christian M / Smith, Albert V / Smith, Blair H / Spracklen, Cassandra N / Strauch, Konstantin / Stumvoll, Michael / Sulem, Patrick / Tajuddin, Salman M / Teren, Andrej / Thiery, Joachim / Thio, Chris H L / Thorsteinsdottir, Unnur / Toniolo, Daniela / Tönjes, Anke / Tremblay, Johanne / Uitterlinden, André G / Vaccargiu, Simona / van der Harst, Pim / van Duijn, Cornelia M / Verweij, Niek / Völker, Uwe / Vollenweider, Peter / Waeber, Gerard / Waldenberger, Melanie / Whitfield, John B / Wild, Sarah H / Wilson, James F / Yang, Qiong / Zhang, Weihua / Zonderman, Alan B / Bochud, Murielle / Wilson, James G / Pendergrass, Sarah A / Ho, Kevin / Parsa, Afshin / Pramstaller, Peter P / Psaty, Bruce M / Böger, Carsten A / Snieder, Harold / Butterworth, Adam S / Okada, Yukinori / Edwards, Todd L / Stefansson, Kari / Susztak, Katalin / Scholz, Markus / Heid, Iris M / Hung, Adriana M / Teumer, Alexander / Pattaro, Cristian / Woodward, Owen M / Vitart, Veronique / Köttgen, Anna. ·Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. atin1@jhu.edu. · Welch Centre for Prevention, Epidemiology and Clinical Research, Baltimore, MD, USA. atin1@jhu.edu. · Medical Research Council Human Genetics Unit, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. · Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, USA. · Institute of Genetic Epidemiology, Department of Biometry, Epidemiology and Medical Bioinformatics, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany. · Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany. · LIFE Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany. · Target Sciences-Genetics, GlaxoSmithKline, Collegeville, PA, USA. · Department of Medicine and Genetics, University of Pennsylvania, Philadelphia, PA, USA. · Department of Nephrology, University Hospital Regensburg, Regensburg, Germany. · Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany. · Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. · Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. · Division of Quantitative Sciences, Department of Obstetrics & Gynecology, Vanderbilt Genetics Institute, Vanderbilt Epidemiology Center, Institute for Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN, USA. · Biomedical Laboratory Research and Development, Tennessee Valley Healthcare System (626)/Vanderbilt University, Nashville, TN, USA. · deCODE Genetics, Amgen Inc., Reykjavik, Iceland. · Department of Medicine, Division of Nephrology and Hypertension, University of Utah, Salt Lake City, UT, USA. · Genetics, Merck & Co., Inc, Kenilworth, NJ, USA. · Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA. · Strangeways Research Laboratory, University of Cambridge, Cambridge, UK. · Institute of Genetics and Biophysics Adriano Buzzati-Traverso-CNR, Naples, Italy. · Eurac Research, Institute for Biomedicine, Bolzano, Italy. · Laboratory for Statistical Analysis, RIKEN Centre for Integrative Medical Sciences, Yokohama (Kanagawa), Japan. · Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. · Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste, Italy. · Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. · DZHK (German Center for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany. · Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. · Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. · Department of Epidemiology and Biostatistics, Faculty of Medicine, School of Public Health, Imperial College London, London, UK. · Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar, Pakistan. · Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden. · School of Health and Social Studies, Dalarna University, Falun, Sweden. · Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. · Division of Nephrology, University of Washington, Seattle, WA, USA. · Kidney Research Institute, University of Washington, Seattle, WA, USA. · Cardiology, Geneva University Hospitals, Geneva, Switzerland. · Department of Computational Biology, University of Lausanne, Lausanne, Switzerland. · Swiss Institute of Bioinformatics, Lausanne, Switzerland. · Department of Integrative Biomedical Sciences, University of Cape Town, Cape Town, South Africa. · Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA. · Department of Biostatistics, University of Washington, Seattle, WA, USA. · Institute of Molecular Genetics, National Research Council of Italy, Pavia, Italy. · Human Genetics Centre, University of Texas Health Science Centre, Houston, TX, USA. · Hasso Plattner Institute for Digital Health at Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · University of Trieste, Department of Medicine, Surgery and Health Sciences, Trieste, Italy. · Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University of Leipzig, Leipzig, Germany. · Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Regensburg, Regensburg, Germany. · Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK. · Centre for Global Health Research, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK. · Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA. · Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore. · Department of Cardiology, Ealing Hospital, London, UK. · Imperial College Healthcare NHS Trust, Imperial College London, London, UK. · MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, UK. · IRCCS Neuromed, Pozzilli, Italy. · Center for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland. · Institute of Biomedical Technologies, Italy National Research Council, Milano, Italy. · Bio4Dreams, Milano, Italy. · San Raffaele Research Institute, Milano, Italy. · Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, the Netherlands. · Section of Nephrology, Department of Internal Medicine, Leiden University Medical Centre, Leiden, the Netherlands. · Fifth Department of Medicine (Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology), Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. · Department of Genetics, University Medical Center Groningen, Groningen, the Netherlands. · Institute of Physiology, University of Zurich, Zurich, Switzerland. · Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Leipzig, Germany. · Centre for Pediatric Research, University of Leipzig, Leipzig, Germany. · Department of Nephrology and Medical Intensive Care, Charité-Universitätsmedizin Berlin, Berlin, Germany. · Department of Nephrology and Hypertension, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany. · Department of Anatomy and Cell Biology, University Medicine Greifswald, Greifswald, Germany. · Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Baltimore, MD, USA. · Department of Public Health and Caring Sciences, Molecular Geriatrics, Uppsala University, Uppsala, Sweden. · Research Unit of Molecular Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, Neuherberg, Germany. · Institute of Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, Neuherberg, Germany. · German Center for Diabetes Research, Neuherberg, Germany. · QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia. · Icelandic Heart Association, Kópavogur, Iceland. · Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland. · Estonian Genome Centre, Institute of Genomics, University of Tartu, Tartu, Estonia. · Montreal University Hospital Research Centre, Centre Hospitalier de lUniversité de Montréal, Montreal, Quebec, Canada. · Medpharmgene, Montreal, Quebec, Canada. · Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Intramural Research Program, National Institutes of Health, Bethesda, MD, USA. · Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, Graz, Austria. · Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria. · Department of Genetics, Shanghai-MOST Key Laboratory of Health and Disease Genomics, Chinese National Human Genome Centre, Shanghai, China. · Shanghai Industrial Technology Institute, Shanghai, China. · Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. · Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. · National Heart, Lung, and Blood Institute Framingham Heart Study, Framingham, MA, USA. · The Centre for Population Studies, National Heart, Lung, and Blood Institute, Framingham, MA, USA. · Department of Medicine, Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, USA. · Stanford Cardiovascular Institute, Stanford University, Stanford, CA, USA. · Molecular Epidemiology and Science for Life Laboratory, Department of Medical Sciences, Uppsala University, Uppsala, Sweden. · Stanford Diabetes Research Center, Stanford University, Stanford, CA, USA. · The Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland. · Landspitalinn University Hospital, Reykjavík, Iceland. · University of Iceland, Reykjavík, Iceland. · Geisinger Research, Biomedical and Translational Informatics Institute, Rockville, MD, USA. · Department of Clinical Physiology, Tampere University Hospital, and Finnish Cardiovascular Research Center - Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. · Kyoto-McGill International Collaborative School in Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA. · Deutsches Herzzentrum München, Technische Universität München, Munich, Germany. · German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. · Institute of Epidemiology and Biostatistics, University of Ulm, Ulm, Germany. · MRC-PHE Centre for Environment and Health, 323 School of Public Health, Imperial College London, London, UK. · National Heart and Lung Institute, Imperial College London, London, UK. · Integrated Research and Treatment Centre Adiposity Diseases, University of Leipzig, Leipzig, Germany. · Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria. · RIKEN Centre for Integrative Medical Sciences, Yokohama (Kanagawa), Japan. · Division of Biomedical Informatics and Personalized Medicine, School of Medicine, University of Colorado Denver-Anschutz Medical Campus, Aurora, CO, USA. · Nuffield Department of Population Health, University of Oxford, Oxford, UK. · The Charles Bronfman Institute for Personalized Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK. · Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Oxford, UK. · Synlab Academy, Synlab Holding Deutschland GmbH, Mannheim, Germany. · Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria. · Laboratory of Clinical Genome Sequencing, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan. · Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Centre for Environmental Health, Neuherberg, Germany. · Ludwig-Maximilians-Universität München at UNIKA-T Augsburg, Augsburg, Germany. · Institute of Human Genetics, Helmholtz Zentrum München, Neuherberg, Germany. · Institute of Human Genetics, Technische Universität München, Munich, Germany. · Department of Psychiatry, Amsterdam Neuroscience and Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, Amsterdam, the Netherlands. · VA Boston Healthcare System, Boston, MA, USA. · Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Vanderbilt University Medical Centre, Division of Nephrology & Hypertension, Nashville, TN, USA. · Massachusetts Veterans Epidemiology Research and Information Center, VA Cooperative Studies Program, VA Boston Healthcare System, Boston, MA, USA. · Department of Genetics, University of North Carolina, Chapel Hill, NC, USA. · University of Queensland, St Lucia, Queensland, Australia. · Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands. · Institute of Genetic Epidemiology, Helmholtz Zentrum München-German Research Centre for Environmental Health, Neuherberg, Germany. · Chair of Genetic Epidemiology, IBE, Faculty of Medicine, LMU Munich, Munich, Germany. · Department of Internal Medicine I (Cardiology), Hospital of the Ludwig-Maximilians-University Munich, Munich, Germany. · Division of Nephrology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA. · Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA. · Data Tecnica International, Glen Echo, MD, USA. · Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany. · Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland. · Department of Cardiology, Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland. · Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. · Section of Gerontology and Geriatrics, Department of Internal Medicine, Leiden University Medical Centre, Leiden, the Netherlands. · University of Maryland School of Medicine, Baltimore, MD, USA. · Department of Clinical Biochemistry, Landspitali University Hospital, Reykjavik, Iceland. · Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK. · Department of Medicine, Geriatrics Section, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. · Institute of Genetic and Biomedical Research, National Research Council of Italy, UOS of Sassari, Sassari, Italy. · Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland. · Faculty of Medicine, University of Split, Split, Croatia. · Gen-info Ltd, Zagreb, Croatia. · Nephrology Service, Department of Specialties in Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland. · Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK. · Einthoven Laboratory of Experimental Vascular Research, Leiden University Medical Centre, Leiden, the Netherlands. · Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland. · Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland. · Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. · Institute of Physiology, University Medicine Greifswald, Karlsburg, Germany. · Department of Health Sciences, University of Milan, Milano, Italy. · ePhood Scientific Unit, ePhood SRL, Milano, Italy. · Center for Cardiovascular Prevention, First Faculty of Medicine, Charles University and Thomayer Hospital, Prague, Czech Republic. · Thomayer Hospital, Prague, Czech Republic. · Department of Medicine II, First Faculty of Medicine, Charles University, Prague, Czech Republic. · Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, Baltimore, MD, USA. · Molecular Biology and Biochemistry, Gottfried Schatz Research Centre for Cell Signaling, Metabolism and Aging, Medical University of Graz, Graz, Austria. · Neurology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy. · Institute of Molecular Biology and Biochemistry, Centre for Molecular Medicine, Medical University of Graz, Graz, Austria. · Division of Population Health and Genomics, Ninewells Hospital and Medical School, University of Dundee, Dundee, UK. · Division of Endocrinology, Nephrology and Rheumatology, University of Leipzig, Leipzig, Germany. · Heart Centre Leipzig, Leipzig, Germany. · Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany. · Centre de Recherche du CHUM, Montreal, Quebec, Canada. · Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands. · Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. · Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. · Durrer Centre for Cardiovascular Research, the Netherlands Heart Institute, Utrecht, the Netherlands. · Leiden Academic Centre for Drug Research, Leiden University, Leiden, the Netherlands. · Genomics plc, Oxford, UK. · Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany. · Internal Medicine, Department of Medicine, Lausanne University Hospital, Lausanne, Switzerland. · Centre for Population Health Sciences, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK. · Department of Physiology and Biophysics, University of Mississippi Medical Centre, Jackson, MS, USA. · Geisinger Research, Biomedical and Translational Informatics Institute, Danville, PA, USA. · Kidney Health Research Institute, Geisinger, Danville, PA, USA. · Department of Nephrology, Geisinger, Danville, PA, USA. · Division of Kidney, Urologic and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. · Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. · Cardiovascular Health Research Unit, Department of Medicine, Department of Epidemiology, Department of Health Service, University of Washington, Seattle, WA, USA. · Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA. · Department of Nephrology and Rheumatology, Kliniken Südostbayern AG, Traunstein, Germany. · Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK. · Laboratory for Statistical Analysis, RIKEN Centre for Integrative Medical Sciences, Osaka, Japan. · Department of Statistical Genetics, Osaka University Graduate School of Medicine, Osaka, Japan. · Division of Epidemiology, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Centre, Nashville, TN, USA. · Department of Veterans Affairs, Tennessee Valley Healthcare System (626)/Vanderbilt University, Nashville, TN, USA. · Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. anna.koettgen@uniklinik-freiburg.de. · Institute of Genetic Epidemiology, Department of Biometry, Epidemiology and Medical Bioinformatics, Faculty of Medicine and Medical Center-University of Freiburg, Freiburg, Germany. anna.koettgen@uniklinik-freiburg.de. ·Nat Genet · Pubmed #31578528.

ABSTRACT: Elevated serum urate levels cause gout and correlate with cardiometabolic diseases via poorly understood mechanisms. We performed a trans-ancestry genome-wide association study of serum urate in 457,690 individuals, identifying 183 loci (147 previously unknown) that improve the prediction of gout in an independent cohort of 334,880 individuals. Serum urate showed significant genetic correlations with many cardiometabolic traits, with genetic causality analyses supporting a substantial role for pleiotropy. Enrichment analysis, fine-mapping of urate-associated loci and colocalization with gene expression in 47 tissues implicated the kidney and liver as the main target organs and prioritized potentially causal genes and variants, including the transcriptional master regulators in the liver and kidney, HNF1A and HNF4A. Experimental validation showed that HNF4A transactivated the promoter of ABCG2, encoding a major urate transporter, in kidney cells, and that HNF4A p.Thr139Ile is a functional variant. Transcriptional coregulation within and across organs may be a general mechanism underlying the observed pleiotropy between urate and cardiometabolic traits.

7 Article Chronic gout: Barriers to effective management. 2018

Rogenmoser, Sylvie / Arnold, Mark H. ·BAppSci, MD, Junior Medical Officer, Tweed Hospital, Tweed Heads, NSW. · MBBS, FRACP, MBioethics, Associate Professor of Medicine, Sydney Medical Program; Associate Dean and Head, School of Rural Health, University of Sydney, NSW. mark.arnold@sydney.edu.au. ·Aust J Gen Pract · Pubmed #29966174.

ABSTRACT: BACKGROUND: Gout is one of the most common inflammatory arthropathies, and the pathogenesis is well understood. In Australia, most patients with chronic tophaceous gout (CTG) are treated by general practitioners (GPs). Urate-lowering therapy, if adhered to continuously, can suppress the disease, reduce the likelihood of flares and prevent long-term complications such as disfiguring tophi and joint damage. Many rheumatology societies recommend a treat-to-target (T2T) approach, lowering serum urate to 0.35 mmol/L or below with urate lowering therapy. OBJECTIVE: The aim of this article is to discuss inconsistencies in treatment guidelines, identify patient and physician barriers to optimal gout care, explain why a T2T approach is appropriate and make a series of recommendations that are practical for GPs. DISCUSSION: Despite an in-depth understanding of this controllable disease and the availability of simple, safe treatments, chronic gout remains poorly managed. The development of Australian gout guidelines that are easily implemented by GPs is vital and overdue.