TY - JOUR
T1 - Management of acute and recurrent gout
T2 - A clinical practice guideline from the American College of Physicians
AU - Qaseem, Amir
AU - Harris, Russell P.
AU - Forciea, Mary Ann
AU - Denberg, Thomas D.
AU - Barry, Michael J.
AU - Boyd, Cynthia
AU - Chow, R. Dobbin
AU - Fitterman, Nick
AU - Humphrey, Linda L.
AU - Kansagara, Devan
AU - Manaker, Scott
AU - McLean, Robert M.
AU - Vijan, Sandeep
AU - Wilt, Timothy J.
AU - Clinical Guidelines Committee of the American College of Physicians
N1 - Publisher Copyright:
© 2017 American College of Physicians.
PY - 2017/1/3
Y1 - 2017/1/3
N2 - Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of gout. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials; systematic reviews; and large observational studies published between January 2010 and March 2016. Clinical outcomes evaluated included pain, joint swelling and tenderness, activities of daily living, patient global assessment, recurrence, intermediate outcomes of serum urate levels, and harms. Target Audience and Patient Population: The target audience for this guideline includes all clinicians, and the target patient population includes adults with acute or recurrent gout. Recommendation 1: ACP recommends that clinicians choose corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout. (Grade: strong recommendation, high-quality evidence) Recommendation 2: ACP recommends that clinicians use low-dose colchicine when using colchicine to treat acute gout. (Grade: strong recommendation, moderate-quality evidence) Recommendation 3: ACP recommends against initiating longterm urate-lowering therapy in most patients after a first gout attack or in patients with infrequent attacks. (Grade: strong recommendation, moderate-quality evidence) Recommendation 4: ACP recommends that clinicians discuss benefits, harms, costs, and individual preferences with patients before initiating urate-lowering therapy, including concomitant prophylaxis, in patients with recurrent gout attacks.
AB - Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of gout. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials; systematic reviews; and large observational studies published between January 2010 and March 2016. Clinical outcomes evaluated included pain, joint swelling and tenderness, activities of daily living, patient global assessment, recurrence, intermediate outcomes of serum urate levels, and harms. Target Audience and Patient Population: The target audience for this guideline includes all clinicians, and the target patient population includes adults with acute or recurrent gout. Recommendation 1: ACP recommends that clinicians choose corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout. (Grade: strong recommendation, high-quality evidence) Recommendation 2: ACP recommends that clinicians use low-dose colchicine when using colchicine to treat acute gout. (Grade: strong recommendation, moderate-quality evidence) Recommendation 3: ACP recommends against initiating longterm urate-lowering therapy in most patients after a first gout attack or in patients with infrequent attacks. (Grade: strong recommendation, moderate-quality evidence) Recommendation 4: ACP recommends that clinicians discuss benefits, harms, costs, and individual preferences with patients before initiating urate-lowering therapy, including concomitant prophylaxis, in patients with recurrent gout attacks.
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U2 - 10.7326/M16-0570
DO - 10.7326/M16-0570
M3 - Article
C2 - 27802508
AN - SCOPUS:85017113741
SN - 0003-4819
VL - 166
SP - 58
EP - 68
JO - Annals of internal medicine
JF - Annals of internal medicine
IS - 1
ER -