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Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan.
Int J Rheum Dis. 2018 Apr; 21(4):772-787.IJ

Abstract

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.

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Authors+Show Affiliations

Yu KH
Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
Chen DY
Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan.
Chen JH
Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Chen SY
Center of Gout, Country Hospital, Taipei, Taiwan.
Chen SM
Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.
Cheng TT
Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan.
Hsieh SC
Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Hsinchu, Taiwan.
Hsieh TY
Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. Ph.D. Program of Business, Institute of Business, Feng-Chia University, Taichung, Taiwan.
Hsu PF
Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. Department of Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan.
Kuo CF
Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
Kuo MC
Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan.
Lam HC
Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Lee IT
Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Liang TH
Rheumatology Section, Renai Branch, Taipei City Hospital, Taipei, Taiwan.
Lin HY
Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan. Division of Allergy, Immunology and Rheumatology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan.
Lin SC
Division of Rheumatology and Immunology, Cathay General Hospital, Taipei, Taiwan. Department of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.
Tsai WP
Department of Immunology and Rheumatology, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan.
Tsay GJ
Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan.
Wei JC
Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.
Yang CH
Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan. Department of Internal Medicine, Landseed Hospital, Taoyuan, Taiwan.
Tsai WC
Department of Allergy, Immunology, and Rheumatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.

MeSH

BiomarkersComorbidityConsensusDown-RegulationGoutGout SuppressantsHumansHyperuricemiaInterdisciplinary CommunicationRisk FactorsTaiwanTreatment OutcomeUric AcidUricosuric Agents

Pub Type(s)

Consensus Development Conference
Journal Article
Practice Guideline
Review

Language

eng

PubMed ID

29363262

Citation

Yu, Kuang-Hui, et al. "Management of Gout and Hyperuricemia: Multidisciplinary Consensus in Taiwan." International Journal of Rheumatic Diseases, vol. 21, no. 4, 2018, pp. 772-787.
Yu KH, Chen DY, Chen JH, et al. Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan. Int J Rheum Dis. 2018;21(4):772-787.
Yu, K. H., Chen, D. Y., Chen, J. H., Chen, S. Y., Chen, S. M., Cheng, T. T., Hsieh, S. C., Hsieh, T. Y., Hsu, P. F., Kuo, C. F., Kuo, M. C., Lam, H. C., Lee, I. T., Liang, T. H., Lin, H. Y., Lin, S. C., Tsai, W. P., Tsay, G. J., Wei, J. C., ... Tsai, W. C. (2018). Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan. International Journal of Rheumatic Diseases, 21(4), 772-787. https://doi.org/10.1111/1756-185X.13266
Yu KH, et al. Management of Gout and Hyperuricemia: Multidisciplinary Consensus in Taiwan. Int J Rheum Dis. 2018;21(4):772-787. PubMed PMID: 29363262.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan. AU - Yu,Kuang-Hui, AU - Chen,Der-Yuan, AU - Chen,Jiunn-Horng, AU - Chen,Shih-Yang, AU - Chen,Shyh-Ming, AU - Cheng,Tien-Tsai, AU - Hsieh,Song-Chou, AU - Hsieh,Tsu-Yi, AU - Hsu,Pai-Feng, AU - Kuo,Chang-Fu, AU - Kuo,Mei-Chuan, AU - Lam,Hing-Chung, AU - Lee,I-Te, AU - Liang,Toong-Hua, AU - Lin,Hsiao-Yi, AU - Lin,Shih-Chang, AU - Tsai,Wen-Pin, AU - Tsay,Gregory J, AU - Wei,James Cheng-Chung, AU - Yang,Chung-Han, AU - Tsai,Wen-Chan, Y1 - 2018/01/24/ PY - 2018/1/25/pubmed PY - 2018/9/20/medline PY - 2018/1/25/entrez KW - gout KW - hyperuricemia KW - urate-lowering agents SP - 772 EP - 787 JF - International journal of rheumatic diseases JO - Int J Rheum Dis VL - 21 IS - 4 N2 - 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. SN - 1756-185X UR - https://www.unboundmedicine.com/medline/citation/29363262/Management_of_gout_and_hyperuricemia:_Multidisciplinary_consensus_in_Taiwan_ DB - PRIME DP - Unbound Medicine ER -