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Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan
Author(s) -
Yu KuangHui,
Chen DerYuan,
Chen JiunnHorng,
Chen ShihYang,
Chen ShyhMing,
Cheng TienTsai,
Hsieh SongChou,
Hsieh TsuYi,
Hsu PaiFeng,
Kuo ChangFu,
Kuo MeiChuan,
Lam HingChung,
Lee ITe,
Liang ToongHua,
Lin HsiaoYi,
Lin ShihChang,
Tsai WenPin,
Tsay Gregory J.,
Wei James ChengChung,
Yang ChungHan,
Tsai WenChan
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13266
Subject(s) - gout , medicine , hyperuricemia , intensive care medicine , kidney disease , diabetes mellitus , uric acid , guideline , endocrinology , pathology
Gout is an inflammatory disease manifested by the deposition of monosodium urate (MSU) crystals in joints, cartilage, synovial bursa, tendons or soft tissues. Gout is not a new disease, which was first documented nearly 5,000 years ago. The prevalence of gout has increased globally in recent years, imposing great disease burden worldwide. Moreover, gout or hyperuricemia is clearly associated with a variety of comorbidities, including cardiovascular diseases, chronic kidney disease, urolithiasis, metabolic syndrome, diabetes mellitus, thyroid dysfunction, and psoriasis. To prevent acute arthritis attacks and complications, earlier use of pharmacotherapeutic treatment should be considered, and patients with hyperuricemia and previous episodes of acute gouty arthritis should receive long‐term urate‐lowering treatment. Urate‐lowering drugs should be used during the inter‐critical and chronic stages to prevent recurrent gout attacks, which may elicit gradual resolution of tophi. The goal of urate‐lowering therapy should aim to maintain serum uric acid (sUA) level <6.0 mg/dL. For patients with tophi, the initial goal can be set at lowering sUA to <5.0 mg/dL to promote tophi dissolution. The goal of this consensus paper was to improve gout and hyperuricemia management at a more comprehensive level. The content of this consensus paper was developed based on local epidemiology and current clinical practice, as well as consensuses from two multidisciplinary meetings and recommendations from Taiwan Guideline for the Management of Gout and Hyperuricemia.