Tuesday, December 1, 2015

Gout (Part 1) at the ACR 2015 Meeting in San Francisco

There has been a multitude of publications on Gout at the ACR 2015 Annual Meeting in San Francisco. I’ve select my personal highlights and updates. The first part leaves out studies on drugs.

Chang-Fu Kuo an colleagues presented: “Impact of Gout on the Risk of Atrial Fibrillation”. They’ve looked at “45,378 incident gout patients and 45,378 age-, sex-, practice-, registration year- and index year-matched controls”. Results: “The prevalence of AF at index date in gout patients (male, 72.3%; mean age, 62.4 ± 15.1 years) was 7.42% (95% confidence interval [CI], 7.18%–7.66%) and in matched controls 2.83% (95% CI, 2.67%–2.98%). […]” Conclusion: “This population-based study indicates that gout is independently associated with a higher risk of AF at diagnosis and the risk is also higher after the diagnosis.” Hart data, that detecting and treating hyperuricaemic patients is warranted!

Paras Karmacharya and colleagues looked at: “Seasonal Variation in Acute Gouty Arthritis: Data from Nationwide Inpatient Sample”. Conclusion: “Unlike previous studies, our analysis found the peak incidence of acute gout in the fall with its peak in the month of November. […]. They should have left it at this, but they speculate in their conclusion: “Various environmental (temperature, humidity, diet, physical activity) and biochemical factors (low cortisol levels, high absolute neutrophil counts and plasminogen activator inhibitor-1) have been implicated for the seasonal variation. There have been conflicting data on the correlation of the incidence of acute gouty arthritis with environmental factors such as temperature or humidity.” I take out of this abstract, that there is an interesting seasonal variation, which could be useful for campaigns on lowering uric acid levels and/or gout.

Jeewoong Choi and colleagues presented: “Dietary Patterns (DASH, Prudent, Western Diets) and the Risk of Gout in US Women – the Nurses Health Study”. DASH stands for: Dietary Approaches to Stop Hypertension. The diet lowers blood pressure, reduces cholesterol, and improves insulin sensitivity. And these is based on research. Conclusion: “The Western dietary pattern is associated with an increased risk of gout, which explains the rising burden of gout in Western countries. In contrast, the DASH diet and prudent dietary pattern are associated with a lower risk of gout.  The DASH diet appears to offer an attractive additional nutritional approach for gout, as it also reduces blood pressure in hypertension (present in 74% of gout patients) and is also recommended to prevent CVD (a common comorbidity of gout).” I call this good news for people, who do not like to take medications.

MaryAnn Zhang and colleagues discussed: “Do Omega-3 Fatty Acids Reduce Risk of Recurrent Gout Attacks?” Conclusion: “Dietary ω-3 FA-rich fish consumption had a protective effect for recurrent gout attacks in the community, whereas ω-3 FA supplementation alone, as taken in a self-directed manner, did not.” Why do I like this study? Because I’m opposed to nutraceuticals. ω-3 FA supplements had a p-value of 0.98. ω-3 FA-rich Fish had a p-value of 0.02 in favour of the fish diet.

It’s interesting how many new aspects on gout surface each year at the big meeting! The second part will be on drugs in gout therapy.

Kuo CF, Grainge MJ, Zhang W, Doherty M. Impact of Gout on the Risk of Atrial Fibrillation [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/impact-of-gout-on-the-risk-of-atrial-fibrillation/. Accessed November 16, 2015.

Karmacharya P, Pathak R, Aryal M, Giri S, Donato A. Seasonal Variation in Acute Gouty Arthritis: Data from Nationwide Inpatient Sample [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/seasonal-variation-in-acute-gouty-arthritis-data-from-nationwide-inpatient-sample/. Accessed November 16, 2015.

Choi J, Lu N, Zhang Y, Rai SK, Curhan GC, Choi HK. Dietary Patterns (DASH, Prudent, Western Diets) and the Risk of Gout in US Women – the Nurses Health Study [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/dietary-patterns-dash-prudent-western-diets-and-the-risk-of-gout-in-us-women-the-nurses-health-study/. Accessed November 16, 2015.

Zhang M, Zhang Y, Terkeltaub R, Chen C, Neogi T. Do Omega-3 Fatty Acids Reduce Risk of Recurrent Gout Attacks? [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). http://acrabstracts.org/abstract/do-omega-3-fatty-acids-reduce-risk-of-recurrent-gout-attacks/. Accessed November 16, 2015.


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