Gout is an inflammatory arthritis characterized by sudden, painful inflammation. Gout can affect any joint in an asymmetric distribution. Gouty attacks may be isolated or can be followed by years of recurrent flares. Over time, elevated serum urate levels and tophaceous deposits can lead to deformity and disability from underlying bony erosion. The concept of 'treatment-failure gout' describes a unique population that has been either unable to tolerate allopurinol or who have not experienced normalization of serum urate levels on allopurinol. It is estimated that approximately 1-1.5% of the estimated 3-8 million people with gout in the USA have treatment-failure gout. Pegloticase is an US FDA-approved intravenous medication that is a mammalian recombinant uricase conjugated to monomethoxy polyethylene glycol. Two recent Phase III trials have found pegloticase to be effective in the management of treatment-failure gout. These studies also highlight safety concerns regarding the drug's immunogenicity.
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A prospective study of associations between accelerated biological aging and twenty musculoskeletal disorders.
Commun Med (Lond)
December 2024
Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, Key Laboratory of Environment and Genes Related to Diseases of Ministry of Education of China, Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
Background: Musculoskeletal disorders pose major public health challenges, and accelerated biological aging may increase their risk. This study investigates the association between biological aging and musculoskeletal disorders, with a focus on sex-related differences.
Methods: We analyzed data from 172,332 UK Biobank participants (mean age of 56.
Quality of life and clinical gout assessments during pegloticase with and without methotrexate co-therapy: MIRROR randomized controlled trial exploratory findings.
Rheumatol Adv Pract
November 2024
Rheumatology, Western Washington Arthritis Clinic, Bothell, WA, USA.
Article Synopsis
- Pegloticase effectively lowers serum urate levels in patients with uncontrolled gout, but its use is limited by the development of anti-drug antibodies.
- Co-administration of methotrexate (MTX) was found to enhance the urate-lowering response and reduce the risk of infusion reactions, benefiting patients with limited treatment options.
- In a study involving 100 patients, those receiving pegloticase and MTX showed greater improvements in gout response rates compared to those receiving pegloticase and a placebo after 52 weeks of treatment.
Two still unanswered questions about uric acid and cardiovascular prevention: Is a specific uric acid cut-off needed? Is hypouricemic treatment able to reduce cardiovascular risk?
Nutr Metab Cardiovasc Dis
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Cardiology- Heart Failure and Transplants, Cardiotoracovascular Department "A. De Gasperis", Milan, Italy; Associazione Nazionale Medici Cardiologi Ospedalieri (ANMCO), Florence, Italy.
Aims: The most frequent consequence of elevated uric acid (UA) levels is the development of gout and urate kidney disease. Besides these effects, several studies have investigated the association between hyperuricemia and cardiovascular (CV) disease. High serum UA has been identified as an important determinant of all-cause and CV mortality and CV events (acute and chronic coronary syndrome, stroke and peripheral artery disease).
View Article and Find Full Text PDFSingular case report of familial hypocalciuric hypercalcemia: a rare diagnosis of hypercalcemia in the older people.
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Clinical Gerontology Department, University Hospital of Saint-Etienne, Saint-Etienne, France.
Objective: to report a case of familial hypocalciuric hypercalcemia (FHH) in an older patient and highlight the diagnostic challenges in geriatric populations.
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Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN.
This report describes the case of a 53-year-old woman with chronic kidney disease (CKD) exacerbated by a gout flare who presented with renal tubular acidosis (RTA), hypokalemia, and hyperuricemia. Despite outpatient management for gouty nephropathy, the patient experienced progressive hypokalemia, leading to hospitalization. Upon admission, she was diagnosed with type 1 RTA, characterized by metabolic acidosis and severe hypokalemia, refractory to initial potassium supplementation.
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