Read on Twitter
#GCAN2020 livestream definitely working and definitely live
@Tuhina_Neogi & Dr Frederic Liote moderating the Early Career Investigator Symposium https://twitter.com/G_CANgout/status/1324086881261363201
@Tuhina_Neogi & Dr Frederic Liote moderating the Early Career Investigator Symposium https://twitter.com/G_CANgout/status/1324086881261363201
#GCAN2020 Gout mini symposium
Dr. Philip Riches, Gout SMART RCT:
Self testing of serum urate (with phone app communication to clinic) in participants with gout, in order to achieve target SU level
vs usual care arm: limited app & flare diary
Close call on recruitment!
Dr. Philip Riches, Gout SMART RCT:
Self testing of serum urate (with phone app communication to clinic) in participants with gout, in order to achieve target SU level
vs usual care arm: limited app & flare diary
Close call on recruitment!
intervention arm vs usual care: 73% vs 15% reached target SU <0.3 mmol/L (=5mg/dL) at 6 months. Wow!
Also positive feedback from participants
@AlisonBays
#GCAN2020
Also positive feedback from participants
@AlisonBays
#GCAN2020
. @SeoyoungCKim with real world evidence of the risk of incident gout associated with SGLT2 inhibitors (vs GLP1 agonist as comparator)
IBM MarketScan data source
active comparator, new user cohort study
Publication here: https://doi.org/10.7326/m19-2610
#GCAN2020
IBM MarketScan data source
active comparator, new user cohort study
Publication here: https://doi.org/10.7326/m19-2610
#GCAN2020
1:1 PS matching -> Cox PH models
SGLT2 inhibitor vs GLP1 agonist comparator: lower incident gout risk, HR 0.64 (95% CI, 0.57 - 0.72)
Similar estimates when DPP4 inhibitor was used as an active comparator
#GCAN2020
SGLT2 inhibitor vs GLP1 agonist comparator: lower incident gout risk, HR 0.64 (95% CI, 0.57 - 0.72)
Similar estimates when DPP4 inhibitor was used as an active comparator
#GCAN2020
Here is the nifty visual abstract for this study from @AnnalsofIM
Stephen Juraschek on gout mgmt in primary care:
Many barriers contribute to inertia around starting ULT in primary care
NHANES study looking at ULT use and SU levels in US adults: https://doi.org/10.1002/acr.22469
#GCAN2020
Many barriers contribute to inertia around starting ULT in primary care
NHANES study looking at ULT use and SU levels in US adults: https://doi.org/10.1002/acr.22469
#GCAN2020
A recommendation -- 2 evidence-based approaches to start immediately:
DASH diet
optimization of HTN (but how? with what meds?)
#GCAN2020
DASH dietoptimization of HTN (but how? with what meds?)#GCAN2020
HTN mgmt with comorbid gout -- finer points:
beta blockers may worsen gout parameters - AASK trial
https://doi.org/10.1093/ajh/hpx113
amlodipine a/w lower risk of gout vs chlorthalidone or lisinopril in ALLHAT trial posthoc analysis https://doi.org/10.1097/hjh.0000000000002359
#GCAN2020
beta blockers may worsen gout parameters - AASK trialhttps://doi.org/10.1093/ajh/hpx113
amlodipine a/w lower risk of gout vs chlorthalidone or lisinopril in ALLHAT trial posthoc analysis https://doi.org/10.1097/hjh.0000000000002359#GCAN2020
John Fitzgerald on the new gout guidelines.
Recommendation against treating asymptomatic hyperuricemia.
Blast from the past: c. 2001 understanding of treating hyperuricemia, with evidence source being a 1941 JAMA article(!)
Something @AdamRodmanMD would like
#GCAN2020
Recommendation against treating asymptomatic hyperuricemia.
Blast from the past: c. 2001 understanding of treating hyperuricemia, with evidence source being a 1941 JAMA article(!)
Something @AdamRodmanMD would like
#GCAN2020
The debate regarding ULT treat to target approach continues (
).
Need to find these letters/commentaries referenced here.
#GCAN2020
). Need to find these letters/commentaries referenced here.
#GCAN2020
An optimal ULT T2T strategy? Focus on patient adherence, via close follow-up and pt education. Ensure flare prophylaxis on board when titrating ULT.
. @ALGaffoRheumMD on the @G_CANgout white paper on gout mgmt in CKD.
Low level of evidence for colchicine and pretty much no data for NSAIDs, steroids, IL-1 inhibitors (including whether renal dosing is necessary - sound familiar @UWRheum fellows/grads?)
#GCAN2020
Low level of evidence for colchicine and pretty much no data for NSAIDs, steroids, IL-1 inhibitors (including whether renal dosing is necessary - sound familiar @UWRheum fellows/grads?)
#GCAN2020
