The Guideline for the Management of Gout
(Part 1)
This discussion is a continuation of the topic which we started last week. The topic is on The Guideline for the Management of Gout.
First, we need to know what gout is. Gout is the most common form of inflammatory arthritis. Gout is a disease that is fully understood and there are plenty of available medicines that can treat the disease.
Gout is characterized by red, tender, hot, and swollen joint. Pain comes on rapidly, reaching maximal intensity in less than 12 hours. The joint at the base of the big toe is affected in about half of cases. Gout may also result to kidney stones, or even kidney damage.
Gout has something to do with persistently elevated levels of uric acid in the blood. This happens because of poor diet, other health problems, and even genetic factors.
Uric acid crystallizes and the crystals are deposited in joints, tendons, and surrounding tissues, resulting in an a gout attack.
Gout happens commonly in those who regularly drink beer or sugar-sweetened beverages or who eat foods that are high in purines such as liver, shellfish, or anchovies, or are overweight.
Gout may be confirmed by a physician through the presence of crystals in the joint fluid or in a deposit outside the joint.
There are some guidelines that use the treat-to-target strategies using urate-lowering therapy (ULT). Over the past 2 decades there has been no increase in ULT use.
Using ULT to treat gout remains lackluster and there is a need to improve adherence as the guidelines have been criticized by some experts. As this developed, the need to come up with new guidelines emerged.
A team of experts has been formed to come up with a new set of guidelines, which consists of rheumatologists, a general internist, a nephrologist, a physician assistant, and a patient representative.
The team then produced 57 population, intervention, comparator, and outcomes (PICO) questions to address issues concerning the use of ULT.
Moreover, in-person patient panel was formed which consisted of 8 male patients with gout, moderated by one of the voting panel members, reviewing the evidence report.
Next week we will discuss the outcome of the formulation of the new guideline that seeks to improve ULT utilization as part of the management of gout.