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A new 'package of care' strategy for effective gout management

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Gout is often poorly managed, with low rates of successful long-term urate lowering. A new 'package of care' intervention for treatment of patients with gout now offers ways to improve outcomes. The intervention, involving both a rheumatologist and gout nurse specialist, provides a framework for best practice in gout management.

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References

  1. Zhang, W. et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT). Ann. Rheum. Dis. 65, 1312–1324 (2006).

    Article  CAS  Google Scholar 

  2. Solomon, D. H., Avorn, J., Levin, R. & Brookhart, M. A. Uric acid lowering therapy: prescribing patterns in a large cohort of older adults. Ann. Rheum. Dis. 67, 609–613 (2008).

    Article  CAS  Google Scholar 

  3. Roddy, E., Zhang, W. & Doherty, M. Concordance of the management of chronic gout in a UK primary-care population with the EULAR gout recommendations. Ann. Rheum. Dis. 66, 1311–1315 (2007).

    Article  CAS  Google Scholar 

  4. Dalbeth, N., Kumar, S., Stamp, L. & Gow, P. Dose adjustment of allopurinol according to creatinine clearance does not provide adequate control of hyperuricemia in patients with gout. J. Rheumatol. 33, 1646–1650 (2006).

    CAS  PubMed  Google Scholar 

  5. Reach, G. Treatment adherence in patients with gout. Joint Bone Spine 78, 456–459 (2011).

    Article  Google Scholar 

  6. Rees, F., Jenkins, W. & Doherty, M. Patients with gout adhere to curative treatment if informed appropriately: proof-of-concept observational study. Ann. Rheum. Dis. http://dx.doi.org/10.1136/annrheumdis-2012-201676.

  7. Hande, K. R., Noone, R. M. & Stone, W. J. Severe allopurinol toxicity. Description and guidelines for prevention in patients with renal insufficiency. Am. J. Med. 76, 47–56 (1984).

    Article  CAS  Google Scholar 

  8. Stamp, L. K. et al. Using allopurinol above the dose based on creatinine clearance is effective and safe in patients with chronic gout, including those with renal impairment. Arthritis Rheum. 63, 412–421 (2011).

    Article  CAS  Google Scholar 

  9. Zhu, Y., Pandya, B. J. & Choi, H. K. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 63, 3136–3141 (2011).

    Article  Google Scholar 

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N. Dalbeth declares that she has acted as a consultant for Ardea Biosciences, Fonterra, Metabolex, Novartis and Takeda. She has received Speakers' honoraria from Novartis, and grant/research support from Fonterra and Novartis. She is a patent holder or applicant for Fonterra.

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Dalbeth, N. A new 'package of care' strategy for effective gout management. Nat Rev Rheumatol 8, 507–508 (2012). https://doi.org/10.1038/nrrheum.2012.129

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