Comparative Performances of Sodium-Glucose Cotransporter-2 Inhibitors in Reducing Gout in Type 2 Diabetes

Nov 8th, 2020 - Among patients with type 2 diabetes (T2D), sodium-glucose cotransporter-2 (SGLT2) inhibitors dapagliflozin and empagliflozin vs canagliflozin show greater benefit in reducing gout, according to research results presented at the American College of Rheumatology (ACR) Convergence 2020, held virtually from November 5 to 9, 2020.

Gout as an Immune-Related Adverse Event from Immune Checkpoint Inhibitors
Kevin Lee, Carrie Ye2 and Shokrollah Elahi, Internal Medicine et. al.

Nov 9th, 2020 - Background/Purpose: Immune checkpoint inhibitors (ICI) are novel treatments approved for various tumours including melanoma, lung and kidney. By interacting with immunoregulatory molecules (programmed death-1 (PD-1), PD-1 ligand (PD-L1), or cytotoxic T-lymphocyte associated protein (CTLA-4)), ICI prevent inhibition of T-cells and thereby increase immune activity. However, this T-cell activation...

Change in Tophus Size Measured with Dual-energy CT and Ultrasound: A 1-year Multicenter Follow-up Study
Tristan Pascart, Pascal Richette, Sebastien Ottaviani et. al.

Nov 9th, 2020 - Background/Purpose: Dual-Energy computed tomography (DECT) and ultrasound are the two techniques able to identify and measure monosodium urate (MSU) crystal deposition, and both are considered for monitoring crystal depletion during urate lowering therapy (ULT). Particularly, both techniques are able to measure tophi, but it is unknown if their assessment of tophus size are correlated throughou...

Management of Gout with Pegloticase; Real-World Utilization and Outcomes from Trio Health and the American Rheumatology Network (ARN)
Nehad Soloman, Mona Amin, Kimmi Cox et. al.

Nov 9th, 2020 - Background/Purpose: Infusion reactions and other adverse events associated with pegloticase may lead to discontinuation of treatment in patient populations that have already failed or are intolerant to other uric acid lowering therapies (ULTs). Maximizing the benefit of pegloticase is critical in the absence of other suitable ULTs. Here, we examine use of pegloticase for patients in US clinical...

Management of Gout After Pegloticase; Observations of US Clinical Practice from Trio Health and the American Rheumatology Network (ARN)
Nehad Soloman, Mona Amin, Simon Helfgott et. al.

Nov 9th, 2020 - Background/Purpose: Pegloticase is approved for severe gout in patients that are intolerant to, or whose disease is ineffectively controlled by, other uric acid lowering therapies (ULTs). The positioning of pegloticase as the last therapeutic option begs the question, how is gout managed once pegloticase is discontinued? Here we examine treatment following pegloticase for patients in US clinica...

The Role of Dual Energy Computed Tomography (DECT) in the Differentiation of Gout and Calcium Pyrophosphate Deposition Disease
Dmitrij Kravchenko, Pantelis Karakostas, Peter Brossart et. al.

Nov 9th, 2020 - Background/Purpose: Differentiation of gout and calcium pyrophosphate deposition disease (CPPD) is sometimes difficult as patients often present with a similar clinical picture. Arthrocentesis and subsequent polarization microscopy (PM) remains the gold standard but novel diagnostic approaches such as non-invasive dual energy computed tomography (DECT) have recently been validated for gout. Cur...

Effectiveness of Dietary Counseling on Gout Management and Risk Factors for Metabolic Syndrome in Gout Patients
Juliana Chang, Jonathan Tsui2 and Maida Wong, Division of Rheumatology et. al.

Nov 9th, 2020 - Background/Purpose: Gout is the most prevalent inflammatory arthritis globally. Despite treatment advances, the prevalence of gout has continued to increase over the last several decades. There has also been increasing evidence that gout has a strong association with the metabolic syndrome. This suggests that gout is likely both an inflammatory and a metabolic disease that has a significant eff...

Assessing Causal Associations of Urate Levels with Type 2 Diabetes and Related Glycemic Traits Using Bidirectional Mendelian Randomization
Natalie McCormick, Mark O'Connor, Shelby Marozoff et. al.

Nov 8th, 2020 - Background/Purpose: Type 2 diabetes (T2D) and gout/hyperuricemia frequently coexist, but the nature and direction of this relationship is unclear.  Observational studies have reported positive associations between gout/SU levels and risk of T2D but are subject to residual confounding or reverse causality bias.  We used bidirectional two-sample Mendelian randomization to obtain unconfounded evid...

Annual Cardiac or Orthopedic Procedure Volume in Gout versus Rheumatoid Arthritis: A National Time-trends Study
Jasvinder Singh1 and John Cleveland, University of Alabama at Birmingham, Birmingham et. al.

Nov 8th, 2020 - Background/Purpose: The hospitalization rate for gout has been increasing in recent years with a reduction in people with RA. To our knowledge, there are no studies of time-trends in U.S. national estimates of cardiac versus orthopedic procedures in people with gout compared to RA. Our study objective was to compare time-trends in cardiac versus orthopedic procedures in people with gout versus ...

Multimorbidity in Rheumatoid Arthritis, Psoriatic Arthritis, Gout, and Osteoarthritis Within the Rheumatology Informatics System for Effectiveness (RISE) Registry
Bryant England, Huifeng Yun, Lang Chen et. al.

Nov 8th, 2020 - Background/Purpose: Rheumatic and musculoskeletal diseases (RMDs) often predispose the development of other chronic conditions, resulting in multimorbidity. While multimorbidity is increasingly being recognized and examined within individual RMDs, few studies have directly compared the burden and pattern of multimorbidity across RMDs. Therefore, we aimed to compare multimorbidity between rheuma...

Changes in Serum Urate, in the First 6-months of Initiation or Change of Urate-Lowering Therapy, Associate with Immediate Health-Related Quality of Life Outcomes in People with Gout
Ruth Topless, Tony Merriman, Siamak Noorbaloochi2 and Jasvinder Singh et. al.

Nov 7th, 2020 - Background/Purpose: Few studies, if any, have found association of the biochemical cause of gout (high serum urate) with functional limitation and health-related quality of life (HRQoL) and productivity decrements in gout. We examined the associations of changes in serum urate in the immediate term with HRQoL using data from five intervention clinical trials of urate-lowering therapies (ULT). M...

Gout and Serum Urate Levels Are Associated with Lumbar Spine Monosodium Urate Deposition and Chronic Low Back Pain: A Dual-Energy CT Study
Michael Toprover, Michael Mechlin, Anastasia Slobodnick et. al.

Nov 7th, 2020 - Background/Purpose: Spinal gout is reported as a rare event, presenting as acute back pain, neuropathy, and spinal compression. Diagnosis is commonly based on identification of a mass, followed by tissue confirmation of monosodium urate (MSU) deposition. It is likely that many more cases of gout involve the spine asymptomatically or with non-specific or under-recognized symptoms. Methods: Using...

Gout Increases Length of Stay in Patients Hospitalized for Heart Failure Exacerbation
Daniel DeMizio, Guojing Wu, Ying Wei et. al.

Nov 7th, 2020 - Background/Purpose: There is growing evidence that both the prevalence of gout and its burden on healthcare costs has increased over recent decades. It has been shown that hospitalization increases the risk of acute gout flare, which may prolong hospital stay compared to those without gout flare. It is unclear whether patients with history of gout would have longer hospital stays in general, or...

Gout Management Beyond Prescription Writing: The Role of the Pharmacist
Emma Dorris, Paul Ryan, Mariosa Kieran et. al.

Nov 7th, 2020 - Background/Purpose: Urate lowering therapy (ULT) is recommended for long-term gout management. However, gout flares are common at the time of starting ULT, and these flares can impact on adherence to ULT. Co-prescription of low dose colchicine as anti-inflammatory prophylaxis is recommended for the first 6 months of ULT. Pharmacists play a key role in community gout education. We investigated p...

Calcium Pyrophosphate Crystal Deposition in Gouty Tophi
Hang-Korng Ea, Alan Gauffenic, Quand Nguyen et. al.

Nov 7th, 2020 - Background/Purpose: The coexistence of calcium pyrophosphate (CPP) and monosodium urate crystals is rarely reported in gouty tophi. We investigated CPP crystal deposits in a series of gouty tophi removed by surgery and associated factors. Methods: 25 tophi from 22 patients were analyzed by light microscopy, field-emission-scanning electron microscopy (FE-SEM) and µ Fourier transform infrared (F...

AR882, a Potent and Selective Uricosuric Agent, Significantly Reduced Serum Urate in Patients with Gout in a Phase 2a Study
Li-Tain Yeh, Elizabeth Polvent, Zancong Shen et. al.

Nov 7th, 2020 - Background/Purpose: AR882 is a potent and selective uric acid transporter 1 (URAT1) inhibitor under development for the treatment of hyperuricemia or gout. Phase 1 single ascending dose and multiple ascending dose clinical studies in healthy adult male subjects demonstrated linear pharmacokinetics and dose-dependent serum uric acid (sUA) lowering effect. A phase 2a study in patients with gout i...

Gout and Heart Failure in the US
Gurkipal Singh, Maanek Sehgal2 and Alka Mithal, Stanford University et. al.

Nov 7th, 2020 - Background/Purpose: Heart failure (HF) is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017 (1).  Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure (2), but there is little nationwide data on the clinical and economic consequences of these comorbidities. The objective was to stu...

Dual-energy CT versus Ultrasound, Alone or in Combination, for the Diagnosis of Gout: A Diagnostic Performance Study
Jasvinder Singh, Fabio Becce, Jean--Francois Budzik3 and Tristan Pascart et. al.

Nov 7th, 2020 - Background/Purpose: To examine the diagnostic accuracy of dual-energy computed tomography (DECT) vs. ultrasound  or their combination for the diagnosis of gout. Methods: Using data from an outpatient rheumatology clinic, we examined the sensitivity, specificity, positive and negative predictive value (PPV, NPV) and area under the receiver operating characteristic (ROC) curve (AUC) of either mod...

Denosumab Did Not Improve Computerized Tomography Erosion Scores When Added to Intensive Urate-Lowering Therapy in Gout: Results from a Pilot Study
Angelo Gaffo, Kenneth Saag, Anthony Doyle et. al.

Nov 7th, 2020 - Background/Purpose: Bone erosion is a common complication of tophaceous gout. Disordered osteoclast activity has been implicated in the pathogenesis of gouty bone erosion.  We sought to determine if the addition of denosumab to intensive urate-lowering therapy (ULT) improves gouty bone erosion through targeting receptor activator of nuclear factor kappa-B ligand (RANKL). Methods: Open-label, pa...

Dual-energy CT Predicts Mortality in Gout Patients: A 3-year Follow-up Cohort Study
Anne Marty-Ané, Laurène Norberciak, Jean--Francois Budzik3 and Tristan Pascart et. al.

Nov 7th, 2020 - Background/Purpose: Cardiovascular events, chronic kidney disease and increased mortality are common in gout patients but what links them remains unclear. Tophaceous gout in particular is associated with higher mortality which raised the potential causal role of the monosodium urate (MSU) crystal burden. The volume of MSU crystal deposition in soft tissues measured with dual-energy computed tom...