In patients with gout, ongoing sUA
elevations can lead to damaging
monosodium urate (MSU) crystal
deposition, and eventually
permanent bone and joint damage.
1
Reference: 1. Taylor JW, Grainger R. Clinical features of gout. In: Terkeltaub R, ed. Gout
and Other Crystal Arthropathies. 1st ed. Philadelphia, PA: Elsevier Saunders; 2012:105-120.
sUA levels
<360 μmol/L
(<6 mg/dL) are
recommended
for all patients
with gout, and
even lower than
that for patients
with extensive
tophi and a high
crystal load.
1-5
References: 1. Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-1324. 2. Richette P, Doherty M, Pascual E,
et al. Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2014;73(suppl 2):S783-S784. 3. Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic
approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64(10):1431-1446. 4. Sivera F, Andres M, Carmona L, et al. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e
initiative. Ann Rheum Dis. 2014;73(2):328-335. 5. Jordan KM, Cameron JS, Snaith M, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-1374.
MSU crystal deposition continues
during asymptomatic periods
between acute gout flares.
1-4
References: 1. Terkeltaub R, Edwards NL. Disease definition and overview of pathogenesis of hyperuricemia and gouty
inflammation. In: Terkeltaub R, Edwards NL, eds. Gout: Diagnosis and Management of Gouty Arthritis and Hyperuricemia.
3rd ed. Durant, OK: Professional Communications, Inc; 2013:19-47. 2. Dalbeth N, Stamp L. Hyperuricaemia and gout: time
for a new staging system? Ann Rheum Dis. 2014;73(9):1598-1600. 3. Schumacher HR Jr. The pathogenesis of gout. Cleve Clin
J Med. 2008;75(suppl 5):S2-S4. 4. Taylor JW, Grainger R. Clinical features of gout. In: Terkeltaub R, ed. Gout and Other
Crystal Arthropathies. 1st ed. Philadelphia, PA: Elsevier Saunders; 2012:105-120.
sUA levels
<360 μmol/L
(<6 mg/dL) are
recommended
for all patients
with gout, and
even lower than
that for patients
with extensive
tophi and a high
crystal load.
1-5
References: 1. Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-1324. 2. Richette P, Doherty M, Pascual E,
et al. Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2014;73(suppl 2):S783-S784. 3. Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic
approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64(10):1431-1446. 4. Sivera F, Andres M, Carmona L, et al. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e
initiative. Ann Rheum Dis. 2014;73(2):328-335. 5. Jordan KM, Cameron JS, Snaith M, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-1374.
To dissolve existing crystals and halt
new crystals from forming, treatment
guidelines recommend keeping sUA levels
consistently at or below 360 μmol/L
(6 mg/dL) in patients with gout,
which is below the MSU saturation point.
1-5
References: 1. Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the
EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-1324. 2. Richette P, Doherty M,
Pascual E, et al. Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2014;73(suppl 2):S783-S784. 3. Khanna D,
Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and
pharmacologic therapeutic approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64(10):1431-1446. 4. Sivera F, Andres M, Carmona L, et al.
Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a
broad panel of rheumatologists in the 3e initiative. Ann Rheum Dis. 2014;73(2):328-335. 5. Jordan KM, Cameron JS, Snaith M, et al. British Society for
Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-1374.
sUA levels
<360 μmol/L
(<6 mg/dL) are
recommended
for all patients
with gout, and
even lower than
that for patients
with extensive
tophi and a high
crystal load.
1-5
References: 1. Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-1324. 2. Richette P, Doherty M, Pascual E,
et al. Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2014;73(suppl 2):S783-S784. 3. Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic
approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64(10):1431-1446. 4. Sivera F, Andres M, Carmona L, et al. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e
initiative. Ann Rheum Dis. 2014;73(2):328-335. 5. Jordan KM, Cameron JS, Snaith M, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-1374.
In up to 90% of patients with gout,
hyperuricemia results from inefficient
renal excretion, possibly due to
alterations in transporter function.
1
Reference: 1. Burns CM, Wortman RL. Clinical features and treatment of gout. In: Firestein GS, Budd RC, Gabriel S,
et al, eds. Kelley's Textbook of Rheumatology. 9th ed. Philadelphia, PA: Elsevier Saunders; 2013:1554-1575.
sUA levels
<360 μmol/L
(<6 mg/dL) are
recommended
for all patients
with gout, and
even lower than
that for patients
with extensive
tophi and a high
crystal load.
1-5
References: 1. Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312-1324. 2. Richette P, Doherty M, Pascual E,
et al. Updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2014;73(suppl 2):S783-S784. 3. Khanna D, Fitzgerald JD, Khanna PP, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 1: systematic nonpharmacologic and pharmacologic therapeutic
approaches to hyperuricemia. Arthritis Care Res (Hoboken). 2012;64(10):1431-1446. 4. Sivera F, Andres M, Carmona L, et al. Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e
initiative. Ann Rheum Dis. 2014;73(2):328-335. 5. Jordan KM, Cameron JS, Snaith M, et al. British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout. Rheumatology (Oxford). 2007;46(8):1372-1374.
March 2015 - Atlas ID: 716.909,011 - Expiry date 13 June 2015