Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan |
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| Authors: | Der‐Yuan Chen Jiunn‐Horng Chen Shih‐Yang Chen Shyh‐Ming Chen Tien‐Tsai Cheng Song‐Chou Hsieh Tsu‐Yi Hsieh Pai‐Feng Hsu Chang‐Fu Kuo Mei‐Chuan Kuo Hing‐Chung Lam I‐Te Lee Toong‐Hua Liang Hsiao‐Yi Lin Shih‐Chang Lin Wen‐Pin Tsai Gregory J. Tsay James Cheng‐Chung Wei Chung‐Han Yang Wen‐Chan Tsai |
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| Affiliation: | 1. Faculty of Medicine, National Yang‐Ming University, Taipei, Taiwan;2. Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;3. Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan;4. Division of Immunology and Rheumatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan;5. School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan;6. Center of Gout, Country Hospital, Taipei, Taiwan;7. Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan;8. Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, Kaohsiung, Taiwan;9. Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, National Taiwan University Hospital, Hsinchu, Taiwan;10. Division of Allergy, Immunology, and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;11. Ph.D. Program of Business, Institute of Business, Feng‐Chia University, Taichung, Taiwan;12. Department of Healthcare and Services Center, Taipei Veterans General Hospital, Taipei, Taiwan;13. Division of Rheumatology, Allergy, and Immunology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan;14. Division of Nephrology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan;15. Faculty of Renal Care, Kaohsiung Medical University, Kaohsiung, Taiwan;16. Division of Endocrinology and Metabolism, Department of Internal Medicine, E‐Da Hospital/I‐Shou University, Kaohsiung, Taiwan;17. Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan;18. Rheumatology Section, Renai Branch, Taipei City Hospital, Taipei, Taiwan;19. Division of Allergy, Immunology and Rheumatology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan;20. Division of Rheumatology and Immunology, Cathay General Hospital, Taipei, Taiwan;21. Department of Medicine, College of Medicine, Fu‐Jen Catholic University, New Taipei, Taiwan;22. Department of Immunology and Rheumatology, Hsinchu MacKay Memorial Hospital, Hsinchu, Taiwan;23. Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan;24. Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan;25. Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan;26. Department of Internal Medicine, Landseed Hospital, Taoyuan, Taiwan;27. Department of Allergy, Immunology, and Rheumatology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan |
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| 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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| Keywords: | gout hyperuricemia urate‐lowering agents |
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