Discordant American College of Physicians and international rheumatology guidelines for gout management: consensus statement of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN).

Details

Ressource 1Download: nrrheum.2017.126.pdf (360.35 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_77D7C83DA30F
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Discordant American College of Physicians and international rheumatology guidelines for gout management: consensus statement of the Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN).
Journal
Nature reviews. Rheumatology
Author(s)
Dalbeth N., Bardin T., Doherty M., Lioté F., Richette P., Saag K.G., So A.K., Stamp L.K., Choi H.K., Terkeltaub R.
ISSN
1759-4804 (Electronic)
ISSN-L
1759-4790
Publication state
Published
Issued date
09/2017
Peer-reviewed
Oui
Volume
13
Number
9
Pages
561-568
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
In November 2016, the American College of Physicians (ACP) published a clinical practice guideline on the management of acute and recurrent gout. This guideline differs substantially from the latest guidelines generated by the American College of Rheumatology (ACR), European League Against Rheumatism (EULAR) and 3e (Evidence, Expertise, Exchange) Initiative, despite reviewing largely the same body of evidence. The Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN) convened an expert panel to review the methodology and conclusions of these four sets of guidelines and examine possible reasons for discordance between them. The G-CAN position, presented here, is that the fundamental pathophysiological knowledge underlying gout care, and evidence from clinical experience and clinical trials, supports a treat-to-target approach for gout aimed at lowering serum urate levels to below the saturation threshold at which monosodium urate crystals form. This practice, which is truly evidence-based and promotes the steady reduction in tissue urate crystal deposits, is promoted by the ACR, EULAR and 3e Initiative recommendations. By contrast, the ACP does not provide a clear recommendation for urate-lowering therapy (ULT) for patients with frequent, recurrent flares or those with tophi, nor does it recommend monitoring serum urate levels of patients prescribed ULT. Results from emerging clinical trials that have gout symptoms as the primary end point are expected to resolve this debate for all clinicians in the near term future.

Pubmed
Web of science
Open Access
Yes
Create date
07/09/2017 8:16
Last modification date
20/08/2019 14:34
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