1
|
Yu KH, Chen DY, Chen JH, Chen SY, Chen SM, Cheng TT, Hsieh SC, Hsieh TY, Hsu PF, Kuo CF, Kuo MC, Lam HC, Lee IT, Liang TH, Lin HY, Lin SC, Tsai WP, Tsay GJ, Wei JCC, Yang CH, Tsai WC. Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan. Int J Rheum Dis 2018; 21:772-787. [PMID: 29363262 DOI: 10.1111/1756-185x.13266] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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.
Collapse
Affiliation(s)
- Kuang-Hui Yu
- Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
| | - Der-Yuan Chen
- 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
| | - Jiunn-Horng Chen
- 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
| | | | - Shyh-Ming Chen
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan
| | - Tien-Tsai Cheng
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan
| | - Song-Chou Hsieh
- Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Hsinchu, Taiwan
| | - Tsu-Yi Hsieh
- 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
| | - Pai-Feng Hsu
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Chang-Fu Kuo
- Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan
| | - Mei-Chuan Kuo
- Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hing-Chung Lam
- Division of Endocrinology and Metabolism, Department of Internal Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - I-Te Lee
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Toong-Hua Liang
- Rheumatology Section, Renai Branch, Taipei City Hospital, Taipei, Taiwan
| | - Hsiao-Yi Lin
- Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Allergy, Immunology and Rheumatology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan
| | - Shih-Chang Lin
- Division of Rheumatology and Immunology, Cathay General Hospital, Taipei, Taiwan.,Department of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Wen-Pin Tsai
- Department of Immunology and Rheumatology, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan
| | - Gregory J Tsay
- 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
| | - James Cheng-Chung Wei
- 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
| | - Chung-Han Yang
- Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.,Department of Internal Medicine, Landseed Hospital, Taoyuan, Taiwan
| | - Wen-Chan Tsai
- Department of Allergy, Immunology, and Rheumatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| |
Collapse
|