Management of Acute and Recurrent Gout
Authors: Vanya D. Wagler, Aaron W. Pumerantz
Journal: Annals of Internal Medicine (2017)

Letters16 May 2017Management of Acute and Recurrent GoutVanya D. Wagler, DO and Aaron W. Pumerantz, DOVanya D. Wagler, DOFrom William Beaumont Army Medical Center, El Paso, Texas.Search for more papers by this author and Aaron W. Pumerantz, DOFrom William Beaumont Army Medical Center, El Paso, Texas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0144 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We note with interest Qaseem and colleagues' clinical practice guideline for management of gout (1). Given the prevalence of this condition, its substantial disease burden, and the availability of potentially curative therapies, skillful and purposeful management by primary care physicians and rheumatologists is imperative. In light of existing clinical practice guidelines by the American College of Rheumatology (2) and the European League Against Rheumatism (3) recommending a “treat-to-target” approach for long-term urate-lowering therapy, seeing a new guideline from the American College of Physicians that suggests an alternative “treat-to-avoid-symptoms” paradigm is surprising.The prospect of administering urate-lowering therapy ...References1. Qaseem A, Harris RP, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Management of acute and recurrent gout: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2017;166:58-68. [PMID: 27802508]. doi:10.7326/M16-0570 LinkGoogle Scholar2. Khanna D, Fitzgerald JD, Khanna PP, Bae S, Singh MK, Neogi T, et al; American College of Rheumatology. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64:1431-46. [PMID: 23024028] doi:10.1002/acr.21772 CrossrefMedlineGoogle Scholar3. Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castañeda-Sanabria J, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76:29-42. [PMID: 27457514] doi:10.1136/annrheumdis-2016-209707 CrossrefMedlineGoogle Scholar4. Schett G, Schauer C, Hoffmann M, Herrmann M. Why does the gout attack stop? A roadmap for the immune pathogenesis of gout. RMD Open. 2015;1:e000046. [PMID: 26557370] doi:10.1136/rmdopen-2015-000046 CrossrefMedlineGoogle Scholar5. Thiele RG, Schlesinger N. Ultrasonography shows active inflammation in clinically unaffected joints in chronic tophaceous gout [abstract]. Arthritis Rheum . 2009;59:S1512. Google Scholar Author, Article, and Disclosure InformationAffiliations: From William Beaumont Army Medical Center, El Paso, Texas.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0144. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoManagement of Acute and Recurrent Gout: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Russell P. Harris , Mary Ann Forciea , and Management of Acute and Recurrent Gout David Erk Management of Acute and Recurrent Gout Russell P. Harris , Robert M. McLean , and Amir Qaseem Metrics 16 May 2017Volume 166, Issue 10Page: 759KeywordsDisclosureForecastingGoutInflammationMorbidityPrimary care physiciansRheumatologyTreatment guidelinesUltrasound imagingUric acid ePublished: 16 May 2017 Issue Published: 16 May 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...