The following is a summary of “What are the core recommendations for gout management in first line and specialist care? Systematic review of clinical practice guidelines,” published in the June 2023 issue of Rheumatology by Conley et al.
Gout is a common, treatable, but often neglected condition. Researchers systematically reviewed to identify, evaluate, and synthesize the most up-to-date Clinical Practice Guidelines (CPGs) on gout management.
The study provided some guidelines for including Gout management CPGs that were written in English and published between January 2015-February 2022, focused on adults aged ≥ 18 years who met the criteria of a CPG as defined by the Institute of Medicine. Reviewers rated them as high quality on the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Gout CPGs that required additional payment to access and only addressed recommendations for the system of care were excluded. They did not include interventional management recommendations or other arthritic conditions. Numerous searches were conducted on OvidSP MEDLINE, Cochrane, CINAHL, Embase, and Physiotherapy Evidence Database (PEDro), and a thorough examination of four online guideline repositories.
The results showed be written better- Result showed six high-quality CPGs, consistently recommending education, non-steroidal anti-inflammatories, colchicine, or corticosteroids (unless contraindicated) for acute gout management. They emphasize evaluating heart disease risks, renal function, and other medical factors. For chronic gout management, urate-lowering therapy (ULT) and personalized prophylaxis are advised based on individual patient characteristics. Further explicit guidelines are needed for ULT initiation, duration, vitamin C intake, and pegloticase, fenofibrate, and losartan.
Investigators concluded acute and chronic gout management is consistent across CPGs, with inconsistent recommendations for ULT and pharmacological therapies.
Source: bmcrheumatol.biomedcentral.com/articles/10.1186/s41927-023-00335-w
