Gout, 1e

Copyright
Dedication
Gout
List of Contributors
Preface
	Reference
1. Hyperuricemia and the Silent Deposition of Monosodium Urate Crystals
	Definition of Hyperuricemia
	Consequences of Hyperuricemia
	Deposits of Monosodium Urate Crystals in Patients with Asymptomatic Hyperuricemia
		Ultrasound
		Dual-Energy Computed Tomography
		Relevance of Silent Deposits
		Pending Agenda
	Disclosure statement
	References
2. Genetics of Hyperuricemia and Gout
	The Genetic Basis of Hyperuricemia
	Molecular Insights Into Urate Control
		Renal Uric Acid Excretion
			SLC2A9
			ABCC4
			PDZK1
		ABCG2 and Gut Uric Acid Excretion
		Metabolic Loci
			Glucokinase regulatory protein
			ALDH2 and ALDH16A1
			LRP2
	The Genetic Basis of Progression From Hyperuricemia to Gout
		Candidate Gene Studies in Gout
		TLR4
			CARD8 and IL1B
			PPARGC1B and mitochondrial DNA copy number
			APOA1
		GWAS With Gout as Outcome
	Mendelian Randomization: Are Hyperuricemia and Gout Causal for Comorbid Metabolic Conditions?
	Precision Medicine
	References
3. Immunoinflammatory Nature of Gout
	Introduction
	Monosodium Urate Crystals Trigger the Activation of the NRLP3 Inflammasome
	Pyroptosis Mediated by Monosodium Urate Crystals
	Inflammatory Signals Influencing Inflammation and Inflammasome Assembly in Gout
	Mechanisms of Inflammasome Assembly in Gout
	IL-1β an Initiator of Inflammation in Gout
	IL-1 Inhibition in Gout
	Mechanisms of Inflammation Resolution in Gout
	Conclusion
	References
4. Tophi: Clinical and Biological Features
	Introduction
	Tophus Pathology
	Mechanisms of Tophus Formation
	Clinical Features of Tophi
	Tophus Imaging
	Tophi and Urate Arthropathies
	Management
	DISCLOSURE
	References
5. Crystal Analysis in Synovial Fluid
	Preparation of the Sample
	Microscope
	Diagnosing Intercritical Gout and CPP Crystal Arthritis
	Some Practical Tips
	Other Characteristics of Synovial Fluid in Crystal Arthritis
	Other Crystals in Synovial Fluid
	Disclosure
	References
6. Epidemiology of Gout and Hyperuricemia
	Introduction
	United States and Canada
		Hyperuricemia
		Gout
			Prevalence
			Incidence
	United Kingdom and Europe
		Hyperuricemia
		Gout
			Prevalence
			Incidence
	Asia and Oceania
		Hyperuricemia
		Gout
			Prevalence
			Incidence
	Africa and the Middle East
		Hyperuricemia
		Gout
			Prevalence
	Global Burden of Gout
	Age, Gender, Ethnicity, and Socioeconomic Deprivation
		Age and Prevalence and Incidence of Gout and Hyperuricemia
		Sex and Prevalence and Incidence of Gout and Hyperuricemia
		Race/Ethnicity and Prevalence and Incidence of Gout and Hyperuricemia
		Socioeconomic Deprivation and Prevalence and Incidence of Gout and Hyperuricemia
	Conclusion
	References
7. Comorbidities in Gout
	Introduction
	Chronic Kidney Disease
	Cardiovascular Disease
	Hypertension
	Hyperlipidemia
	Osteoporosis
	Obesity
	Diabetes
	Other Associations
	Summary
	References
8. Imaging of Gout
	Imaging Techniques Widely Used for Assessment of Gout
		Conventional Radiography
		Ultrasonography
		Magnetic Resonance Imaging
		Conventional Computed Tomography
		Dual-Energy Computed Tomography
	Imaging for the Diagnosis of Gout
	Imaging for Assessment of Disease Severity
	Imaging for Complications of Gout
	Imaging to Measure Response to Therapy
	Imaging to Understand Mechanisms of Disease
	Imaging to Assist With Patient Understanding of Disease and Therapies
	References
	Further Reading
9 - Gout Classification and Diagnosis
	Introduction
	Classification and Diagnostic Criteria
	Early Attempts at Gout Classification: Rome, New York, and American Rheumatism Association Criteria
	The SUGAR Study and 2015 ACR/EULAR Gout Classification Criteria
	Diagnostic Rules on Gout
	Classification of Gout Flares
	Conclusion
	DISCLOSURE STATEMENT
	References
10 - Clinical Features of Gout and Its Impact on Quality of Life
	Gout Flare
	Gouty Tophi
	Chronic GOUT
	Other Manifestations of Gout
	Unusual Presentations of Gout
		Early-Onset Gout
		Gout in Women
		Spinal Gout
	Impact of Gout on Quality of Life
	Disclosure Summary
	References
11 - Quality of Life
	Gout: The Disease and Its Prevalence
	Quality of Life and Health-Related Quality of Life: Concept and Definitions
	Why Measure Quality of Life and Health-Related Quality of Life When We Have Objective Disease Measures in Gout?
	How to Measure Quality of Life and Health-Related Quality of Life? Generic Versus Disease-Specific Measures in Gout
	Pathways to the Impact of Gout on Health-Related Quality of Life and Quality of Life
	Effect of Gout on Health-Related Quality of Life and Quality of Life
	Predictors of Health-Related Quality of Life and Quality of Life in Patients With Gout (Table 11.2)
	Effect of Gout Treatments on Health-Related Quality of Life
		Urate-Lowering Therapies
		Antiinflammatory Drugs
	Is Inappropriate Treatment of Gout Associated With Worse Health-Related Quality of Life?
	Are There Disparities in the Health-Related Quality of Life in Patients With Gout?
	Physical Function: A Concept Related to Quality of Life/Health-Related Quality of Life
	Summary and Conclusions
	Future Directions
	DISCLOSURE STATEMENT
	References
12. Treatment Guidelines: The Good, the Bad, the Ugly
	Introduction
	What Are Clinical Practice Guidelines and How Should They Be Developed?
	Clinical Practice Guidelines for Gout
	On What Do the Guidelines Agree?
		Management of Acute Attacks
		Prophylaxis When Starting Urate-Lowering Therapy
		Patient Education
	On What Do the Guidelines Disagree?
		Dietary Interventions
		Indications for and When to Consider Urate-Lowering Therapy
		Treat-to-Target or Treat-to-Avoid-Symptoms?
	What Are the Implications of These Differences in Guideline Recommendations?
	Conclusion
	DISCLOSURE STATEMENT
	References
13 - Nonpharmacologic Treatment of Gout
	Introduction
	Topical Ice Acute Gout
	Exercise
	Weight Loss
	Low Purine Diet
	Diet Low in Fructose
	Hydration
	Decease in Alcohol Consumption
	Dairy Products
	Coffee
	Fruits and Vegetables
		Fruits
			Cherries
			Lemons
		Vegetables
			Tofu
	High-Protein Diets
	Dietary Supplements
	Vitamins
		Vitamin C
	Traditional Chinese Medicine
	Summary
	References
14 - Pharmacologic Treatments: Acute Gout
	Introduction
	Nonsteroidal Antiinflammatory Drugs
	Colchicine
	Corticosteroids
	Interleukin 1b Antagonists
	References
15 - Current Pharmacological Treatments of Chronic Gout
	Treatment of Chronic Gout
	Urate-Lowering Therapy
	Uricostatic Drugs
		Xanthine Oxidase Inhibitors
		Allopurinol
		Febuxostat
	Uricosuric Drugs
		Probenecid
		Lesinurad
		Losartan
		Fenofibrate
		Benzbromarone
	Uricolytic Drugs
		Pegloticase
	Urate-Lowering Therapy Drugs Are Effective
	Poor Adherence to Urate-Lowering Therapy
	Treatment of Chronic Gout Is Not Just About Urate-Lowering Therapy
		Prophylaxis
		Colchicine
		Nonsteroidal Antiinflammatory Drugs
		Interleukin-1 Inhibitors
	Poor Adherence to Prophylaxis
	Conclusion
	References
16 -  Treat to Target
	Origins of the Treat-to-Target Concept
	Evidence for Treat-to-Target Approaches
		Treat to Target in Gout
		Symptom-Focused Approach: The Natural History of Gout
		Serum Urate–Focused Approach: Impact on Outcomes
	Serum Urate Targets in Gout
		Therapeutic Serum Urate Targets
		Preventive Serum Urate Target
		How Fast, How Low, How Long Should We Lower Serum Urate Level?
	DISCLOSURE STATEMENT
	References
17. Drugs in the Pipeline
	Introduction
	New Antiinflammatory Strategies
		Targeting Interleukin-1β in Acute and Chronic Gout
			Anakinra
			Canakinumab
			Rilonacept
		Other Novel Antiinflammatory Strategies
			Dapansutrile (OLT-1177)
			Bucillamine
	New Approaches to Serum Urate Lowering
		Agents That Inhibit Urate Synthesis
			Topiroxostat
			Ulodesine
		Agents That Promote Urate Degradation
			Pegloticase
			Pegsiticase
			Rasburicase
		Agents That Promote Urate Excretion
			Lesinurad
			Verinurad
			UR-1102
			Tofisopam
			Drugs with incidental uricosuric benefits
	Drugs With Mixed Mechanisms
		Arhalofenate
		Tranilast
		RLBN1001
	Beyond the Pipeline: Possible Future Strategies?
	Conclusion
	DISCLOSURE STATEMENT
	References
Index
	A
	B
	C
	D
	E
	F
	G
	H
	I
	J
	K
	L
	M
	N
	O
	P
	Q
	R
	S
	T
	U
	V
	W
	X
	Y
Epilogue
	References