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Rheumatology

Gout   

Questions discussed in this category

If a patient who has tolerated allopurinol for a prolonged period of time is subsequently found to be positive for the HLA-B*58:01 gene, how would you manage urate-lowering therapy thereafter?
1 Answer available
Are there certain patients in whom you would avoid initiation of ULT during an acute gout flare?
This question is part of a collaboration with RheumMadness and is specifically in reference to: ULT During Gout Flare.
3 Answers available
Are there patients with gout in whom you would choose febuxostat first line over allopurinol for urate lowering therapy?
This question is part of a collaboration with RheumMadness and is specifically in reference to: Allopurinol vs. Febuxostat
1 Answer available
Do you ever taper or stop urate lowering therapy in patients who have had no gout flares and serum urate persistently below 6 mg/dl?
In patients with CKD, does urate lowering therapy have an effect (positive or negative) on progression of CKD?
1 Answer available
How do you approach urate-lowering therapy in patients with advanced chronic kidney disease?
What doses of allopurinol do you use, and how frequently do you titrate the dose?
1 Answer available
How do you approach transaminase elevations with use of allopurinol in gout?
Do you rechallenge with lower dose? What is your tolerance for mild persistent transaminitis?
1 Answer available
When do you consider discontinuing Pegloticase in a patient with tophaceous gout who has had excellent response to therapy?
1 Answer available
What is your approach to treating tophaceous gout in patients whose uric acid is below 5 prior to initiating uric acid lowering therapy?
1 Answer available
How do you use colchicine for gout in patients with chronic kidney disease or end-stage renal disease on hemodialysis?
2 Answers available
Is there any utility in checking HLA-B*5801 in our Black and Asian patients who are already tolerating allopurinol?
1 Answer available
What is your approach for gout flare prophylaxis in patients with diabetes and advanced CKD?
Preference for low dose steroids vs attempting colchicine? 
1 Answer available
Is it ever appropriate to reduce urate lowering therapy dose due to very low urate levels?
Are there implications of reducing urate too much?
1 Answer available
Do you screen for HLA-B*5801 prior to starting allopurinol in patients of backgrounds other than Asian or African-American?
Specifically in patients of Vietnamese background? An association has been shown between HLA-B*5801 and the risk of allopurinol hypersensitivity react...
1 Answer available
How do you determine when to transition off pegloticase to other uric acid lowering therapies?
1 Answer available
Do you eventually stop urate-lowering therapy in gout patients with CKD who start hemodialysis?
1 Answer available
When have you found Dual-Energy CT most useful in evaluating for gout?
3 Answers available
In gout, do MSU crystals form only in tissue, or are there circulating microcrystals of MSU within blood vessels?
If so, does this have clinical significance?
2 Answers available
Is it ever appropriate to initiate a higher initial dose of allopurinol (such as 300mg daily) than is typically recommended in gout patients at low risk of allopurinol hypersensitivity syndrome and severe hyperuricemia?
2 Answers available


Papers discussed in this category

Rheumatology (Oxford), 2021 Jan 07
Dual-energy computed tomography versus ultrasound, alone or combined, for the diagnosis of gout: a prospective study of accuracy.
Clinical and experimental rheumatology, 2018
Update on imaging in gout: contrasting and comparing the role of dual-energy computed tomography to traditional diagnostic and monitoring techniques.
The Journal of rheumatology, 2004-12
Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis.
Arthritis and rheumatism, 2008-09
Reduction of plasma urate levels following treatment with multiple doses of pegloticase (polyethylene glycol-conjugated uricase) in patients with treatment-failure gout: results of a phase II randomized study.
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2014-12
Infusion-related reactions with pegloticase, a recombinant uricase for the treatment of chronic gout refractory to conventional therapy.
Curr Rheumatol Rep, 2022 Feb 15
Expert Opinion on Pegloticase with Concomitant Immunomodulatory Therapy in the Treatment of Uncontrolled Gout to Improve Efficacy, Safety, and Durability of Response.
Arthritis and rheumatism, 2008-11
Resolution of gouty tophi after twelve weeks of pegloticase treatment.
Arthritis Rheumatol, 2020 Jan
Effects of Conventional Uric Acid-Lowering Therapy on Monosodium Urate Crystal Deposits.
Arthritis Care Res (Hoboken), 2020 May 11
2020 American College of Rheumatology Guideline for the Management of Gout.
Arthritis Rheum, 2002 Aug
Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout.
Arthritis care & research, 2012-10
2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia.
Proceedings of the National Academy of Sciences of the United States of America, 2005 Mar 02
HLA-B*5801 allele as a genetic marker for severe cutaneous adverse reactions caused by allopurinol.

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