Poster authors are responsible for removing their posters at the end of the day. Arrange your poster components to read from left to right and top to bottom. Gout is the most common form of inflammatory arthritis, affecting ~9.2 million adults (3.9%) in the US 1. Do patient preferences for core outcome domains for chronic gout studies support the validity of composite response criteria? A series of cases should be used to illustrate the topic being presented. 2011 . Kidney International (Suppl. We recommend using a treat‐to‐target management strategy to optimize patient outcomes by achieving and maintaining an SU target of <6 mg/dl rather than using a fixed‐dose strategy (Table 3 and Supplementary Figure 2, available at http://onlin​elibr​ary.wiley.com/doi/10.1002/acr.24180/​abstract). In a large cohort study, obesity was associated with a higher risk of incident gout, but not recurrent gout flares 105. A small cohort study demonstrated that despite receiving ULT, heavy drinkers (≥30 units of alcohol/week) were more likely to continue having gout flares compared with those who do did not drink heavily 95. Fig. We thank Jasvinder A. Singh for leading the Patient Panel meeting, as well as the patients who participated in this meeting: Lynn Brown, Jr., Douglas P. Davis, Larry Davis, Dextral L. Ely, Adam Paul Germek, Willie Earl Henton, James Edward Sims, and James Trucks. FDA adds boxed warning for increased risk of death with gout medicine Uloric (febuxostat), Cardiovascular safety of febuxostat or allopurinol in patients with gout, Assessment of cardiovascular risk in older patients with gout initiating febuxostat versus allopurinol, Major cardiovascular events in patients with gout and associated cardiovascular disease or heart failure and chronic kidney disease initiating a xanthine oxidase inhibitor, Risk factors associated with renal lithiasis during uricosuric treatment of hyperuricemia in patients with gout, Lesinurad combined with allopurinol: a randomized, double‐blind, placebo‐controlled study in gout patients with an inadequate response to standard‐of‐care allopurinol (a US‐based study), Long‐term safety of pegloticase in chronic gout refractory to conventional treatment, Treat to target in rheumatoid arthritis: fact, fiction, or hypothesis? While conditionally recommending against ULT initiation following the first gout flare in a patient with “uncomplicated” gout, the Voting Panel considered Patient Panel input and recognized that there may be patients who would prefer (or benefit from) ULT, underscoring the need for shared decision‐making. However, the recommendation for treat‐to‐target strategy is not absolute and not meant to be pursued at “any cost.” Even strong recommendations require sound clinical judgment to balance the potential clinical benefits and harms (including costs) of medical decisions 78. An in‐person Patient Panel of 8 male patients with gout, moderated by one of the voting panel members (JAS), reviewed the evidence report (along with a summary and interpretation by the moderator) and provided patient perspectives and preferences. There is moderate‐ and high‐quality evidence supporting these 2 recommendations. Patients with evidence of monosodium urate monohydrate (MSU) deposition on advanced imaging may still be considered asymptomatic if they have not had a prior gout flare or subcutaneous tophi. However, changes in body mass index (BMI) over time were associated with the risk of recurrent gout flare. Noting limited supporting data 91, the Voting Panel recommended the use of topical ice as an adjuvant therapy for flares. The Voting Panel indicated that an optimal trial of oral medication would be appropriate prior to pegloticase due to cost differences and potential adverse effects of the latter medication (for recommendations for choice of initial ULT, see Table 2 and Supplementary Figure 2, available at http://onlinelibrary.wiley.com/doi/10.1002/acr.24180/abstract). We thank N. Lawrence Edwards, MD, for his review of the manuscript. Furthermore, patients with higher SU concentrations after withholding therapy had more frequent flares with greater likelihood of flares associated with higher SU levels 37. As use of uricosurics remains infrequent, we did not formally vote on indications for uricosuric medications. However, in contrast to a treatment strategy using an SU target of <6 mg/dl as studied in clinical trials 43, there are no trial data to support lower specific thresholds for such patients. The Patient Panel representative stated members would be willing to accept “some” incremental CVD risk as long as the treatment adequately controlled their gout. ; View abstracts about a certain topic by visiting the keyword index. 2021 abstract presentation guidelines coming soon. For patients with a history of urolithiasis, allopurinol and febuxostat provide benefit, as both medications lower 24‐hour urinary uric acid excretion more than placebo 33. If you are ready to order click on the button below to start. This is also the case for patients with asymptomatic hyperuricemia with MSU crystal deposition as noted on imaging tests such as ultrasound or dual‐energy computed tomography. For patients in clinical remission taking ULT (e.g., no flares for ≥1 year and no tophi 63), the Voting Panel considered ULT cessation or tapering. The College cannot be responsible for these materials and any posters not removed at the end of the daily sessions will be discarded. 2. Accepted submissions will be published in the same online supplement of Arthritis and Rheumatology as the 2018 scientific abstracts, and displayed as a digital poster … The full text of this article hosted at iucr.org is unavailable due to technical difficulties. ; Access the meetings archive to view abstracts from previous meetings. Dr. Neogi had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Although likely to render only modest urate‐lowering effects, switching from an angiotensin‐converting enzyme inhibitor to losartan carries a risk that seems to be sufficiently low in most patients to merit this change when feasible (for all recommendations for management of concurrent medications, see Table 8 and Supplementary Figure 5, available at http://onlinelibrary.wiley.com/doi/10.1002/acr.24180/abstract). Several lesinurad studies demonstrated the benefit of adding a uricosuric medication to XOI treatment 25, 76. Similarly, patients with markedly elevated SU concentrations (>9 mg/dl) are more likely to experience gout progression 26, 32. Gout has differential impact on patients by sex, race, or by presence of other comorbidities. The ESR uses the ACR's guidelines as a starting point for reviewed and adapted guidelines for use in Europe. Join us for the leading event in radiology - ECR 2021, March 3-7, 2021. The certainty of evidence from the other 2 outcomes was then designated as important but not critical to support the recommendation. An applied science presentation may be a paper, a hardcopy poster, a digital poster or a stand-alone computer display. Explore available award and grant opportunities for fellows-in-training. The HLA–B*5801 allele is associated with a markedly elevated risk for AHS 64, 65. Working off-campus? The National Patient Safety Agency (NPSA) and Royal College of Radiologists (RCR) developed a specific checklist adapted for radiological interventions, based on the WHO Surgical Safety Checklist with emphasis first on the intervention suite but increasing attention to all invasive procedures including ‘biopsies and other invasive tissue sampling’ (1). Notifications of acceptance and rejection will be sent for the general abstract submissions (coming soon). Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowl- edge, technology, and practice. 7 Fig. Similar to the 2012 ACR Guidelines for the Management of Gout, the Voting Panel advocated a “medication‐in‐pocket” strategy for gout flare management, which the Patient Panel reinforced as a preferred approach. The Voting Panel considered data from the CARES RCT 72 and 2 observational studies 73, 74. Adherence to urate-lowering therapy while following the national guidelines for the management of patients with gout (preliminary evidence). Medication costs (not part of the systematic literature review), reported as average wholesale pricing as sourced from Lexicomp on August 23, 2019, were provided to the Voting Panel, as cost of treatment was included as part of the evaluation of risks and benefits of treatment medications (see Supplementary Appendix 9, available on the Arthritis Care & Research web site at http://onlin​elibr​ary.wiley.com/doi/10.1002/acr.24180/​abstract). Management: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT), British Society for Rheumatology and British Health Professionals in Rheumatology guideline for the management of gout, 2016 updated EULAR evidence‐based recommendations for the management of gout, Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study, Comparison of drug adherence rates among patients with seven different medical conditions, The evidence basis for the American College of Rheumatology practice guidelines, The long and winding road to clinical guidelines on the diagnosis and management of gout, GRADE: an emerging consensus on rating quality of evidence and strength of recommendations, The GRADE Working Group clarifies the construct of certainty of evidence, Defining certainty of net benefit: a GRADE concept paper, Outcome measures for gout clinical trials: a summary of progress. To become a recommendation (for or against) in this guideline, at least 70% consensus of the Voting Panel was required. This review is done by the ESR Referral Guidelines Subcommittee (RG SC) that was established at ECR 2016 (originally as a working group) as part of the … Read your poster over carefully to check for spelling mistakes. Outcomes varied across PICO topic (for details, see Supplementary Appendix 3, at http://onlin​elibr​ary.wiley.com/doi/10.1002/acr.24180/​abstract). In the National Health and Nutrition Examination Survey, artificially sweetened carbonated beverage consumption was associated with higher SU levels 101. Faculty of Radiologists European Working Time Directive position Oct 2009. Abstracts can be submitted via the online submission form or alternatively in a Word document submission form and sent to conference@bir.org.uk. 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