Gout is a condition that resulted from deposition of monosodium urate crystals in various tissues (eg joints, connective tissue, kidney).
The patient experiences acute and chronic arthritis, soft tissue inflammation, tophus formation, gouty nephropathy and nephrolithiasis.
Primary hyperuricemia occurs when uric acid saturation arises without coexisting diseases or drugs that alter uric acid production or excretion, while secondary hyperuricemia is a condition where excessive uric acid production or diminished renal clearance occurs as a result of a disease, drug, dietary product or toxin.
Gout entails an increased risk of advanced chronic kidney disease (CKD), and the risk is strongest for the outcome of end-stage kidney disease (ESKD) but extended to other surrogate measures of CKD progression, a study has found.
Ultrasound may provide valuable information for the differential diagnosis of acute erosive arthritis, with a recent study showing that subcutaneous tissue changes and periosteal vascularity are more common in acute osteomyelitis (OM), whereas periosteal tophaceous material distinguishes gouty arthritis from acute OM and rheumatoid arthritis.
Uric acid-lowering therapy for gout also confers benefits for hyperlipidaemia, with febuxostat delivering greater reductions in cholesterol and triglyceride concentrations in the blood as compared with allopurinol and benzbromarone, according to a recent study.
The European League Against Rheumatism (EULAR) updates its recommendations for diagnosing gout, putting emphasis on three diagnostic approaches: establishing monosodium urate crystal deposition via synovial fluid analysis, identifying suggestive and associated clinical features of gout and hyperuricaemia, or performing imaging studies for evidence of MSU crystals.
In the treatment of gout, the risk of nonfatal cardiovascular (CV) events, including myocardial infarction and stroke, does not significantly differ between allopurinol and febuxostat, a study has shown.
Intake of sugar-sweetened beverage and fruit juice appears to increase the risk of developing gout, and this adverse association does not extend to fruit consumption, according to the results of a meta-analysis.
Biweekly treatment with pegloticase yields favourable effects on systolic and diastolic blood pressure as well as mean arterial pressure in gout patients who maintain a persistently low serum urate, and these effects are independent of changes in renal function, according to a posthoc analysis of two trials.
Eating fish rich in n-3 polyunsaturated fatty acid (PUFA) leads to a lower risk of recurrent gout attacks, a study has found. On the other hand, n-3 PUFA supplements such as fish oil and cod liver oil do not confer the same benefit.