Management of gout and hyperuricemia: Multidisciplinary consensus in Taiwan

Kuang Hui Yu, 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 YangWen Chan Tsai*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

107 Scopus citations

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 pharmacothera-peutic 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.

Original languageEnglish
Pages (from-to)772-787
Number of pages16
JournalInternational Journal of Rheumatic Diseases
Volume21
Issue number4
DOIs
StatePublished - 2018

Bibliographical note

Publisher Copyright:
© 2018 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Keywords

  • Gout
  • Hyperuricemia
  • Urate-lowering agents

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