Author: Dálifer Freites Núñez
Tedeschi et al. (0234) performed a secondary analysis using data from the Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout (CARES) trial. Among 6183 participants in this analysis, median age was 65 years and 84.0% were male. Median follow-up was 32 months. Gout flare rates were persistently higher when SU ≥6 mg/dL compared to SU at target after the first year of ULT, after accounting for censoring. These data suggest a potential benefit of achieving very low SU levels (≤3.9 mg/dL) and consideration of a longer duration of prophylaxis to reduce gout flares.
Wei et al. (0251) aimed to examine the relation of SGLT2i vs. active comparators (i.e., glucagon-like peptide-1 receptor agonist or dipeptidyl peptidase 4 inhibitors) to the risk of recurrent gout flares, the first recurrent gout flare, and all-cause mortality among patient with gout and type 2 diabetes. During 17,729 person-years of follow-up, 318 recurrent flares occurred in the 1,548 initiators of SGLT2i and 1,714 in the 4,383 initiators of active comparators, respectively. SGLT2i were associated with a lower risk of recurrent gout flares and mortality than their active comparators in patients with gout and type 2 diabetes. These findings suggested that SGLT2i have the potential to reduce the burden of recurrent gout flares and narrow the mortality gap between patients with gout and the general population.
Qu et al. (0814) found In a post-hoc analysis from a large, randomized double-blind, non-inferiority trial, that serum urate achievement following a T2T strategy was associated with a 60% greater odds of remaining flare-free between 49 and 72 weeks of follow-up. These results support ACR guidelines that endorse a T2T strategy in gout management and demonstrate that benefits in flare prevention may begin to occur as early as 12 to 18 months.
Peral-Garrido et al. (1101) explored whether the presence of subclinical monosodium urate crystal deposition leads to a pro-inflammatory state in asymptomatic hyperuricemia (AH). They aimed to compare the inflammatory state in peripheral blood between AH patients with and without sonographic deposits. The inflammatory state was comparable in AH between those with and without sonographic deposits. Some hints were noted for hsCRP, IL-6, and TNF-α that further studies with larger sizes must confirm to establish the relevance of subclinical crystal deposition in AH.
Mandl et al. (1115) Presented the EULAR Recommendations for the use of Imaging in the Diagnosis and Management of Crystal-induced Arthropathies in Clinical Practice. 5 overarching principles and 10 recommendations were produced on the role of imaging in making a diagnosis, monitoring inflammation, structural damage and crystal deposition, predicting severity and treatment effect, guiding intervention, and patient education in CiA. Overall, the LoA for the recommendations was very high (8.5-9.9).
ABOUT THE AUTHOR
Dálifer Freites Núñez
Dálifer Freites Núñez, Rheumatologist at Hospital Clínico San Carlos, Madrid- Spain and PhD candidate at Complutense University of Madrid.
Dálifer is a member of the EMEUNET Social Media committee with a genuine interest and enthusiasm in research on Immune-mediated inflammatory diseases and its treatments.