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‘Invaluable’ guideline update launched on gout management

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Urate-lowering drugs should be offered to all gout patients early in the course of their disease rather than waiting for them to develop disabling symptoms, according to updated clinical guidance.

The British Society for Rheumatology has today published updated guidelines on the management of gout, noting that the condition is the most searched for term on its website.

“Wide dissemination and implementation of this guideline will have an immediate impact”

Edward Roddy

The society highlighted that the painful form of arthritis was becoming more common but continued to be poorly managed in both primary and secondary care.

The new document is an update of previous guidance from the society, created in response to increases in gout incidence, prevalence and severity, availability of new treatment options, continuing sub-optimal management, and better understanding of the barriers to effective care.

The society stated that the most “important change” from the previous version was recommending that “curative” treatment with urate-lowering drugs should be offered to all patients early in the course of their disease, rather than waiting for them to develop troublesome, disabling symptoms.

In addition, it said all patients with gout should be screened for cardiovascular risk factors and co-morbid conditions such as cigarette smoking, hypertension, diabetes mellitus, dyslipidaemia, obesity and renal disease.

Overall, the society said the key recommendations fell into three areas – management of acute attacks, modification of lifestyle and risk factors, and optimal use of urate-lowering therapies.

“Gout is common, excruciatingly painful and certainly not confined to the 18th century”

Elizabeth MacPhie

It highlighted that several recommendations in the guideline were intended to support health professionals in helping their patients to manage their own condition through information.

It added that the guideline also contained specific recommendations for managing gout in special groups – patients with renal sufficiency, severe refractory tophaceous gout, and in pregnancy.

Guideline lead author Dr Edward Roddy, reader in rheumatology and consultant rheumatologist at Keele University, said: “The guideline will be invaluable for UK practitioners in managing the condition and in guiding professionals towards the key advice and information to pass on to their patients.

“Wide dissemination and implementation of this guideline will have an immediate impact on clinical care in specialist rheumatology as well as general practice,” he said.

Dr Elizabeth MacPhie, chair of the society’s working group on standards, audit and guidelines, added: “Gout is our most ‘in demand’ guideline. This is because gout is common, excruciatingly painful and certainly not confined to the 18th century, as the public might believe.”

The updated guideline, which is accredited by the National Institute for Health and Care Excellence, has been published on the British Society for Rheumatology’s website.

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