dc.contributor.author |
FitzGerald, John D |
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dc.contributor.author |
Dalbeth, Nicola |
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dc.contributor.author |
Mikuls, Ted |
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dc.contributor.author |
Brignardello-Petersen, Romina |
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dc.contributor.author |
Guyatt, Gordon |
en |
dc.contributor.author |
Abeles, Aryeh M |
en |
dc.contributor.author |
Gelber, Allan C |
en |
dc.contributor.author |
Harrold, Leslie R |
en |
dc.contributor.author |
Khanna, Dinesh |
en |
dc.contributor.author |
King, Charles |
en |
dc.contributor.author |
Levy, Gerald |
en |
dc.contributor.author |
Libbey, Caryn |
en |
dc.contributor.author |
Mount, David |
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dc.contributor.author |
Pillinger, Michael H |
en |
dc.contributor.author |
Rosenthal, Ann |
en |
dc.contributor.author |
Singh, Jasvinder A |
en |
dc.contributor.author |
Sims, James Edward |
en |
dc.contributor.author |
Smith, Benjamin J |
en |
dc.contributor.author |
Wenger, Neil S |
en |
dc.contributor.author |
Bae, Sangmee Sharon |
en |
dc.contributor.author |
Danve, Abhijeet |
en |
dc.contributor.author |
Khanna, Puja P |
en |
dc.contributor.author |
Kim, Seoyoung C |
en |
dc.contributor.author |
Lenert, Aleksander |
en |
dc.contributor.author |
Poon, Samuel |
en |
dc.contributor.author |
Qasim, Anila |
en |
dc.contributor.author |
Sehra, Shiv T |
en |
dc.contributor.author |
Sharma, Tarun Sudhir Kumar |
en |
dc.contributor.author |
Toprover, Michael |
en |
dc.contributor.author |
Turgunbaev, Marat |
en |
dc.contributor.author |
Zeng, Linan |
en |
dc.contributor.author |
Zhang, Mary Ann |
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dc.contributor.author |
Turner, Amy S |
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dc.contributor.author |
Neogi, Tuhina |
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dc.date.accessioned |
2020-06-08T22:46:54Z |
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dc.date.issued |
2020-06 |
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dc.identifier.issn |
2326-5191 |
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dc.identifier.uri |
http://hdl.handle.net/2292/51378 |
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dc.description.abstract |
OBJECTIVE:To provide guidance for the management of gout, including indications for and optimal use of urate-lowering therapy (ULT), treatment of gout flares, and lifestyle and other medication recommendations. METHODS:Fifty-seven population, intervention, comparator, and outcomes questions were developed, followed by a systematic literature review, including network meta-analyses with ratings of the available evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, and patient input. A group consensus process was used to compose the final recommendations and grade their strength as strong or conditional. RESULTS:Forty-two recommendations (including 16 strong recommendations) were generated. Strong recommendations included initiation of ULT for all patients with tophaceous gout, radiographic damage due to gout, or frequent gout flares; allopurinol as the preferred first-line ULT, including for those with moderate-to-severe chronic kidney disease (CKD; stage >3); using a low starting dose of allopurinol (≤100 mg/day, and lower in CKD) or febuxostat (<40 mg/day); and a treat-to-target management strategy with ULT dose titration guided by serial serum urate (SU) measurements, with an SU target of <6 mg/dl. When initiating ULT, concomitant antiinflammatory prophylaxis therapy for a duration of at least 3-6 months was strongly recommended. For management of gout flares, colchicine, nonsteroidal antiinflammatory drugs, or glucocorticoids (oral, intraarticular, or intramuscular) were strongly recommended. CONCLUSION:Using GRADE methodology and informed by a consensus process based on evidence from the current literature and patient preferences, this guideline provides direction for clinicians and patients making decisions on the management of gout. |
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dc.format.medium |
Print-Electronic |
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dc.language |
eng |
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dc.relation.ispartofseries |
Arthritis & rheumatology (Hoboken, N.J.) |
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dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
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dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
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dc.subject |
Humans |
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dc.subject |
Gout |
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dc.subject |
Colchicine |
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dc.subject |
Allopurinol |
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dc.subject |
Anti-Inflammatory Agents, Non-Steroidal |
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dc.subject |
Gout Suppressants |
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dc.subject |
Rheumatology |
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dc.subject |
United States |
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dc.subject |
Febuxostat |
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dc.title |
2020 American College of Rheumatology Guideline for the Management of Gout. |
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dc.type |
Journal Article |
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dc.identifier.doi |
10.1002/art.41247 |
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pubs.issue |
6 |
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pubs.begin-page |
879 |
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pubs.volume |
72 |
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dc.rights.holder |
Copyright: The author |
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pubs.end-page |
895 |
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pubs.publication-status |
Published |
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dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
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pubs.subtype |
Research Support, Non-U.S. Gov't |
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pubs.subtype |
Practice Guideline |
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pubs.subtype |
Journal Article |
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pubs.elements-id |
802073 |
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pubs.org-id |
Medical and Health Sciences |
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pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Medicine Department |
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dc.identifier.eissn |
2326-5205 |
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pubs.record-created-at-source-date |
2020-05-12 |
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pubs.dimensions-id |
32390306 |
en |