2021 Asia-Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout

Lorenzo JPP 1 , Sollano MHMZ 1 , Salido EO 2 , Li-Yu J 3 , Tankeh-Torres SA 4 , Wulansari Manuaba IAR 5 Show all authors , Rahman MM 6 , Paul BJ 7 , Mok MY 8 , De Silva M 9 , Padhan P 10 , Lim AL 11 , Marcial M 3 , Vicera JJ 3 , Haq SA 12 , Salman S 13 , Liyanage CK 14 , Keen HI 15 , Yew Kuang C 16 , Wei JC 17 , Hellmi RY 18 , Chan CE 19 , Louthrenoo W 20

Affiliations 

  • 1 Makati Medical Center, Makati City, Philippines
  • 2 College of Medicine, University of the Philippines Manila, Manila, Philippines
  • 3 University of Santo Tomas, Manila, Philippines
  • 4 Cardinal Santos Medical Center, San Juan City, Philippines
  • 5 Bali International University, Bali, Indonesia
  • 6 Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 7 KMCT Medical College, Calicut, India
  • 8 Department of Biomedical Sciences, City University of Hong Kong, Kowloon, Hong Kong
  • 9 National Hospital of Sri Lanka, Colombo, Sri Lanka
  • 10 Department of Clinical Immunology and Rheumatology, Kalinga Institute of Medical Sciences, KIIT University, Bhubaneswar, India
  • 11 Hospital Pulau Pinang, Penang, Malaysia
  • 12 Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
  • 13 Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
  • 14 Department of Pharmacology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
  • 15 University of Western and Perth, Perth, WA, Australia
  • 16 Farrer Park Medical Center, Singapore, Singapore
  • 17 Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
  • 18 Rheumatology Division, Dr Kariadi General Hospital Medical Center, Diponegoro University, Semarang, Indonesia
  • 19 De Los Santos Medical Center, Quezon City, Philippines
  • 20 Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Int J Rheum Dis, 2022 Jan;25(1):7-20.
PMID: 34931463 DOI: 10.1111/1756-185X.14266

Abstract

BACKGROUND: Gout is the most prevalent inflammatory arthritis in the Asia-Pacific region and worldwide. This clinical practice guideline (CPG) aims to provide recommendations based on systematically obtained evidence and values and preferences tailored to the unique needs of patients with gout and hyperuricemia in Asia, Australasia, and the Middle East. The target users of these guidelines are general practitioners and specialists, including rheumatologists, in these regions.

METHODS: Relevant clinical questions were formulated by the Steering Committee. Systematic reviews of evidence were done, and certainty of evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation methodology. A multi-sectoral consensus panel formulated the final recommendations.

RESULTS: The Asia-Pacific League of Associations for Rheumatology Task Force developed this CPG for treatment of gout with 3 overarching principles and 22 recommendation statements that covered the treatment of asymptomatic hyperuricemia (2 statements), treatment of acute gout (4 statements), prophylaxis against gout flare when initiating urate-lowering therapy (3 statements), urate-lowering therapy (3 statements), treatment of chronic tophaceous gout (2 statements), treatment of complicated gout and non-responders (2 statements), treatment of gout with moderate to severe renal impairment (1 statement), and non-pharmacologic interventions (5 statements).

CONCLUSION: Recommendations for clinically relevant scenarios in the management of gout were formulated to guide physicians in administering individualized care.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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