COMMENTARY

Managing Gout as a Systemic Disease

Arefa Cassoobhoy, MD, MPH

Disclosures

November 15, 2018

Hello. I'm Dr Arefa Cassoobhoy, a primary care internist, Medscape advisor, and senior medical director for WebMD. Welcome to Medscape Morning Report, our 1-minute news story for primary care.

A new study adds more proof that gout should be managed like a chronic disease, using a treat-to-target approach to uric acid levels.

The researchers looked at a cohort of almost 1200 patients attending a gout clinic between 1992 and 2017. Of this cohort, 92% of the patients were men with a mean age of 60. The men had gout for about 7 years and averaged three to four flares per year.

The study showed that the patients whose serum uric acid levels were greater than 6 mg/dL were twice as likely to die prematurely compared with those whose levels were below 6 mg/dL.

Optimizing uric acid levels has long been a goal in gout management to reduce long-term morbidity, including cardiovascular and chronic kidney disease. But now patients and providers need to talk about improving survival when choosing treatments that aim for a stable uric acid level less than 6 mg/dL.

Follow Dr Cassoobhoy on Twitter at @ArefaMD

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