dc.contributor.author |
Dalbeth Nicola |
|
dc.contributor.author |
Choi Hyon K |
|
dc.contributor.author |
Joosten Leo AB |
|
dc.contributor.author |
Khanna Puja P |
|
dc.contributor.author |
Matsuo Hirotaka |
|
dc.contributor.author |
Perez-Ruiz Fernando |
|
dc.contributor.author |
Stamp Lisa K |
|
dc.date.accessioned |
2020-11-11T19:57:30Z |
|
dc.date.available |
2020-11-11T19:57:30Z |
|
dc.date.issued |
2019-9-26 |
|
dc.identifier.issn |
2056-676X |
|
dc.identifier.uri |
http://hdl.handle.net/2292/53535 |
|
dc.description.abstract |
Gout is a chronic disease caused by monosodium urate (MSU) crystal deposition. Gout typically presents as an acute, self-limiting inflammatory monoarthritis that affects the joints of the lower limb. Elevated serum urate level (hyperuricaemia) is the major risk factor for MSU crystal deposition and development of gout. Although traditionally considered a disorder of purine metabolism, altered urate transport, both in the gut and the kidneys, has a key role in the pathogenesis of hyperuricaemia. Anti-inflammatory agents, such corticosteroids, NSAIDs and colchicine, are widely used for the treatment of gout flare; recognition of the importance of NLRP3 inflammasome activation and bioactive IL-1β release in initiation of the gout flare has led to the development of anti-IL-1β biological therapy for gout flares. Sustained reduction in serum urate levels using urate-lowering therapy is vital in the long-term management of gout, which aims to dissolve MSU crystals, suppress gout flares and resolve tophi. Allopurinol is the first-line urate-lowering therapy and should be started at a low dose, with gradual dose escalation. Low-dose anti-inflammatory therapies can reduce gout flares during initiation of urate-lowering therapy. Models of care, such as nurse-led strategies that focus on patient engagement and education, substantially improve clinical outcomes and now represent best practice for gout management. |
|
dc.format.medium |
Electronic |
|
dc.language |
eng |
|
dc.publisher |
NATURE PUBLISHING GROUP |
|
dc.relation.ispartofseries |
Nature reviews. Disease primers |
|
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. |
|
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
|
dc.subject |
Humans |
|
dc.subject |
Gout |
|
dc.subject |
Uric Acid |
|
dc.subject |
Adrenal Cortex Hormones |
|
dc.subject |
Gout Suppressants |
|
dc.subject |
Risk Factors |
|
dc.subject |
1103 Clinical Sciences |
|
dc.subject |
Clinical |
|
dc.subject |
Clinical Medicine and Science |
|
dc.subject |
Arthritis |
|
dc.subject |
Inflammatory and Immune System |
|
dc.subject |
Science & Technology |
|
dc.subject |
Life Sciences & Biomedicine |
|
dc.subject |
Medicine, General & Internal |
|
dc.subject |
General & Internal Medicine |
|
dc.subject |
MONOSODIUM URATE MONOHYDRATE |
|
dc.subject |
SERUM URIC-ACID |
|
dc.subject |
QUALITY-OF-LIFE |
|
dc.subject |
3RD NATIONAL-HEALTH |
|
dc.subject |
PURINE-RICH FOODS |
|
dc.subject |
EVIDENCE-BASED RECOMMENDATIONS |
|
dc.subject |
ALLOPURINOL DOSE-ESCALATION |
|
dc.subject |
CUTANEOUS ADVERSE-REACTIONS |
|
dc.subject |
PRIMARY-CARE POPULATION |
|
dc.subject |
US GENERAL-POPULATION |
|
dc.title |
Gout. |
|
dc.type |
Journal Article |
|
dc.identifier.doi |
10.1038/s41572-019-0115-y |
|
pubs.issue |
1 |
|
pubs.begin-page |
69 |
|
pubs.volume |
5 |
|
dc.date.updated |
2020-10-08T22:52:32Z |
|
dc.rights.holder |
Copyright: The author |
en |
pubs.author-url |
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000488819400001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=6e41486220adb198d0efde5a3b153e7d |
|
pubs.publication-status |
Published |
|
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Review |
|
pubs.subtype |
Journal Article |
|
pubs.subtype |
Research Support, N.I.H., Extramural |
|
pubs.elements-id |
783828 |
|
dc.identifier.eissn |
2056-676X |
|
pubs.number |
ARTN 69 |
|