2016 updated EULAR evidence-based recommendations for the management of gout
| Autor: | Fabio Becce, Frédéric Lioté, Jakub Zavada, George Nuki, Johann Castañeda-Sanabria, Florence Tubach, Leonardo Punzi, Weiya Zhang, Michael Doherty, V. Barskova, M. Coyfish, S Guillo, T.L.Th.A. Jansen, Thomas Bardin, Till Uhlig, Hein J.E.M. Janssens, J. Pimentao, Pascal Richette, Eliseo Pascual, Alexander So, Anne-Kathrin Tausche, T Pywell, Fernando Perez-Ruiz, Christian D Mallen |
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| Rok vydání: | 2017 |
| Předmět: |
Genetics and Molecular Biology (all)
Delphi Technique Gout Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Pharmacology Biochemistry chemistry.chemical_compound 0302 clinical medicine Adrenal Cortex Hormones Immunology and Allergy 030212 general & internal medicine Xanthine oxidase inhibitor Evidence-Based Medicine Anti-Inflammatory Agents Non-Steroidal Lesinurad Symptom Flare Up Patient perspective Pegloticase Febuxostat medicine.drug musculoskeletal diseases medicine.medical_specialty Treatment medicine.drug_class Immunology Directive Counseling Allopurinol General Biochemistry Genetics and Molecular Biology Gout Suppressants Multidisciplinary team-care 03 medical and health sciences Patient Education as Topic Rheumatology Internal medicine medicine Humans Life Style 030203 arthritis & rheumatology business.industry Evidence-based medicine medicine.disease Uric Acid Biochemistry Genetics and Molecular Biology (all) chemistry business Rheumatism Interleukin-1 |
| Zdroj: | Annals of the Rheumatic Diseases, 76, 1, pp. 29-42 ANNALS OF THE RHEUMATIC DISEASES r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante instname r-FISABIO: Repositorio Institucional de Producción Científica Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) Annals of the Rheumatic Diseases, 76, 29-42 r-FISABIO. Repositorio Institucional de Producción Científica |
| ISSN: | 0003-4967 |
| Popis: | BackgroundNew drugs and new evidence concerning the use of established treatments have become available since the publication of the first European League Against Rheumatism (EULAR) recommendations for the management of gout, in 2006. This situation has prompted a systematic review and update of the 2006 recommendations.MethodsThe EULAR task force consisted of 15 rheumatologists, 1 radiologist, 2 general practitioners, 1 research fellow, 2 patients and 3 experts in epidemiology/methodology from 12 European countries. A systematic review of the literature concerning all aspects of gout treatments was performed. Subsequently, recommendations were formulated by use of a Delphi consensus approach.ResultsThree overarching principles and 11 key recommendations were generated. For the treatment of flare, colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), oral or intra-articular steroids or a combination are recommended. In patients with frequent flare and contraindications to colchicine, NSAIDs and corticosteroids, an interleukin-1 blocker should be considered. In addition to education and a non-pharmacological management approach, urate-lowering therapy (ULT) should be considered from the first presentation of the disease, and serum uric acid (SUA) levels should be maintained at)and )in those with severe gout. Allopurinol is recommended as first-line ULT and its dosage should be adjusted according to renal function. If the SUA target cannot be achieved with allopurinol, then febuxostat, a uricosuric or combining a xanthine oxidase inhibitor with a uricosuric should be considered. For patients with refractory gout, pegloticase is recommended.ConclusionsThese recommendations aim to inform physicians and patients about the non-pharmacological and pharmacological treatments for gout and to provide the best strategies to achieve the predefined urate target to cure the disease. |
| Databáze: | OpenAIRE |
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