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Management of gout |
Shekelle PG, FitzGerald J, Newberry SJ, Motala A, O'Hanlon CE, Okunogbe A, Tariq A, Han D, Dudley W, Shanman R, Booth M |
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Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Shekelle PG, FitzGerald J, Newberry SJ, Motala A, O'Hanlon CE, Okunogbe A, Tariq A, Han D, Dudley W, Shanman R, Booth M. Management of gout. Rockville: Agency for Healthcare Research and Quality (AHRQ). Comparative Effectiveness Review No. 176. 2016 Authors' objectives Gout is the most common form of inflammatory arthritis and is characterized by acute intermittent episodes of synovitis presenting with joint swelling and pain (referred to as acute gouty arthritis, or acute gout attacks, or acute gout flares). It has been described as a disease of the foot since antiquity. Approximately 8 million
patients in the United States have gout. Gout is caused when excess urate in the body crystalizes (as monosodium urate [MSU]) in joint fluid, cartilage, bones, tendons, bursas or other sites. These crystals can directly stimulate an acute inflammatory attack. In some patients, acute gout attacks become progressively
more frequent, protracted, and severe and may eventually progress to a chronic inflammatory condition. Additionally, in some patients the deposits of urate crystals grow into larger collections, called tophi (singular tophus) when clinically apparent.
The aim of this report is to review the evidence for the treatment of patients with gout, focusing on the primary care setting. Authors' conclusions Several drugs show moderate-to-high evidence of benefit in terms of reducing pain in patients with acute gout. It is clear that urate lowering therapy achieves its goal of lowering urate levels. Decreased serum urate should lead, over time, to a reduction in gout attacks, but the benefits and harms of long term urate lowering therapy have yet to be demonstrated directly. Patient preferences are likely to be important in decision-making (as specified above), and having better estimates of the size of the benefit of urate lowering therapy will make clinicians and patients more knowledgeable about the risk: benefit trade-off for the different decisions. Indexing Status Subject indexing assigned by CRD MeSH Arthritis, Gouty; Gout; Humans; Hyperuricemia; Pain; Uric Acid Language Published English Country of organisation United States English summary An English language summary is available. Address for correspondence AHRQ, Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA Email: AHRQTAP@ahrq.hhs.gov AccessionNumber 32016000543 Date abstract record published 16/03/2016 |
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