Die Gicht als Systemerkrankung

Ak, Tausche; Manger, Bernhard; Müller‐Ladner, Ulf; Schmidt, Börge

doi:10.1007/s00393-011-0953-9

Cited by 16 publications

(4 citation statements)

References 37 publications

(38 reference statements)

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“…This flare is characterized by an acute onset (maximum within 24 hours) of a heavily inflamed and extremely painful mono- or oligoarthritis which often results in short-term sick leave [6]. Serum urate (sUA) concentration above the limit of solubility (>6.8 mg/dL/400 μmol/L) leads to crystal deposition which is a necessary precursor for this disease, though many with hyperuricemia will never develop gout [7,8]. Gout patients whose sUA is maintained below 6 mg/dL (360 μmol/L) over time can expect to remain flare free and this is a most important aspect of long-term management of gout [9-12].…”

Section: Introductionmentioning

confidence: 99%

Tophi and frequent gout flares are associated with impairments to quality of life, productivity, and increased healthcare resource use: Results from a cross-sectional survey

Khanna

Nuki

Bardin

et al. 2012

Health Qual Life Outcomes

163

112

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BackgroundThe prevalence of gout is increasing, and most research on the associated burden has focused on serum urate (sUA) levels. The present study quantifies the impact of the presence of tophi and frequency of acute gout attacks on health-related quality of life (HRQOL), productivity, and healthcare resource utilization.MethodsPatients with self-reported gout (n = 620; 338 in US and 282 across France, Germany, and UK) were contacted based on inclusion in the 2010 US and EU National Health and Wellness Surveys (Kantar Health) and the Lightspeed Research ailment panel. Respondents were categorized into mutually-exclusive groups based on number of gout flares experienced in the past 12 months (0/don’t recall, 1–2, 3, 4–5, 6+), current presence of tophi (none, 1+, or not sure), and sUA level awareness (yes, no). HRQOL (SF-12v2), healthcare provider visits in the last 6 months, and work productivity and activity impairment (WPAI) were compared across groups.ResultsMost patients were males, mean age of 61 years, who reported experiencing at least one acute gout flare in the past 12 months, and 12.3% (n = 76) reported presence of tophi. Among the 27.7% (n = 172) of patients who were aware of their sUA levels, higher sUA was associated with more flares and tophi. Decreased HRQOL was associated with more frequent flares and presence of tophi. In multivariable models predicting outcomes based on presence of tophi and number of flares, both flares (≥4) and tophi (≥1) were associated with HRQOL decrements on physical and mental component summary scores and health utilities (all p < 0.05), after adjustment for age, gender, and time since diagnosis. Flares were also associated with greater activity impairment.ConclusionsImpairments associated with gout flares and presence of tophi, across patients in the US and EU, underscore the importance of effective management of this potentially curable condition.

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Section: Introductionmentioning

confidence: 99%

Tophi and frequent gout flares are associated with impairments to quality of life, productivity, and increased healthcare resource use: Results from a cross-sectional survey

Khanna

Nuki

Bardin

et al. 2012

Health Qual Life Outcomes

163

112

View full text Add to dashboard Cite

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“…1) [6]. Ein polyartikulärer Befall ist initial nur selten [7]. Die Schmerzen können so stark sein, dass der Patient den Druck der Bettdecke oder Erschütterungen im Raum kaum ertragen kann.…”

Section: Pathogenese Der Hyperurikämie Und Ihrer Klinischen Manifestationenunclassified

Hyperurikämie und Gicht

Gröbner¹

2015

Dtsch med Wochenschr

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In most cases (98-99 %) primary hyperuricemia is caused by impaired renal excretion of uric acid. Overproduction of uric acid is rare. Secondary hyperuricemia has to be differentiated from primary forms. Clinical manifestations of hyperuricemia are acute inflammatory arthritis, tenosynovitis, bursitis, chronic arthropathy and accumulation of urate crystals in the form of tophaceous deposits. In addition renal complications can occur. Pathophysiology and diagnosis of gout were described. Treatment of gout has two goals: Treatment of the acute gout attack, to terminate pain and disability and treatment of hyperuricemia by lifestyle modification and with urate lowering drugs. A serum uric acid value below 6 mg/dl (360 µmol/L) should be achieved.

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“… 5 If not treated adequately, gout is a debilitating disease with systemic manifestations, such as monosodium urate crystal deposition in organs and worsening of cardiorenal function. 6 , 7 In addition to gout flares, patients with gout frequently have a high burden of cardiovascular comorbidities, which might explain, in part, the high cardiovascular mortality when compared with the general population. 8 During the past 20 years, gout has been shown to be an independent cardiovascular risk factor, with higher cardiovascular mortality than in the general population.…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout

Hansildaar

Vedder

Baniaamam

et al. 2021

The Lancet Rheumatology

147

111

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The increased risk of cardiovascular morbidity and mortality in rheumatoid arthritis and gout has been increasingly acknowledged in past decades, with accumulating evidence that gout, just as with rheumatoid arthritis, is an independent cardiovascular risk factor. Although both diseases have a completely different pathogenesis, the underlying pathophysiological mechanisms in systemic inflammation overlap to some extent. Following the recognition that systemic inflammation has an important causative role in cardiovascular disease, anti-inflammatory therapy in both conditions and urate-lowering therapies in gout are expected to lower the cardiovascular burden of patients. Unfortunately, much of the existing data showing that urate-lowering therapy has consistent beneficial effects on cardiovascular outcomes in patients with gout are of low quality and contradictory. We will discuss the latest evidence in this respect. Cardiovascular disease risk management for patients with rheumatoid arthritis and gout is essential. Clinical guidelines and implementation of cardiovascular risk management in daily clinical practice, as well as unmet needs and areas for further investigation, will be discussed.

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Die Gicht als Systemerkrankung

Cited by 16 publications

References 37 publications

Tophi and frequent gout flares are associated with impairments to quality of life, productivity, and increased healthcare resource use: Results from a cross-sectional survey

Tophi and frequent gout flares are associated with impairments to quality of life, productivity, and increased healthcare resource use: Results from a cross-sectional survey

Hyperurikämie und Gicht

Cardiovascular risk in inflammatory arthritis: rheumatoid arthritis and gout

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