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, |LORENZO Et aL. | INTRODUC TI ONGout is the most prevalent inflammatory arthritis in the Asia-Pacific region and worldwide. 1 Its prevalence increased steadily in various countries: 2.7% in the 1990s to 3.9% in early 2000 in the United States and from 3.4 per 1000 in 2007 to 7.6 per 1000 persons in 2015 in Korea. 2,3 The prevalence is higher in certain ethnic groups.The risk for tophi formation tends to be higher after controlling for age, gender, hypertension, diuretic use, and kidney function. 4 Varying prevalence across ethnic groups indicates that genetics affects its development and the individual's risk when exposed to environmental or dietary variables. 5,6 Despite scientific advancements, disease control of gout is suboptimal. 2,3 Clinical practice guidelines (CPG) from Western and several Asian countries have provided recommendations for the management of gout. [7][8][9] However, the need to formulate unified Asia-Pacific recommendations was recognized. This CPG aims to provide evidence-based recommendations in managing gout in its different phases: asymptomatic hyperuricemia, acute gout, intercritical gout, and chronic tophaceous or complicated gout. It covers both pharmacologic and non-pharmacologic interventions (NPI) with consideration of the unique needs of patients with gout in Asia, Australasia, and the Middle East. The target users of these guidelines are general practitioners and specialists, including rheumatologists, in different clinical settings in these regions. | G UIDELINE DE VELOPMENT ME THODSThe Steering Committee (SC) formed the guideline development working groups (GDG), formulated the guideline questions (Table 1) in PICO (population, intervention, comparator, and outcome) format, and oversaw the CPG processes (Figure 1). The Technical Working Group (TWG) appraised and summarized the evidence, applied the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology to determine the certainty of evidence, and drafted the recommendations.The Consensus Panel (CP) was composed of 9 key stakeholders (rheumatologists, general practitioners, academicians, and a patient representative) from Australia,

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High-dose celecoxib (800/400 mg) was significantly more effective than low-dose celecoxib (50 mg bid) and comparable to indomethacin in the treatment of moderate to extreme pain in patients with acute gouty arthritis. Further, celecoxib was well tolerated.

Osteoporosis is the most common metabolic bone disease in humans. It is a special concern not only among postmenopausal women, but men as well. In developing countries where there are meager resources, it will definitely be helpful to search for ways to identify patients with low bone mineral density who have a high risk of future fractures. These people need to be identified for treatment consideration in order to reduce the incidence of the disease and its complications. A simple risk index called the Osteoporosis Screening Tool for Asians (OSTA), based only on two variables, age and body weight, performed well in identifying the risk of osteoporosis among postmenopausal women. This index has been validated in Japan, Korea and other Caucasian populations as a useful tool in identifying individuals who will require BMD measurement. This is the first study that validated the said index in 1,597 Filipino women and men referred to a tertiary center for BMD measurement. It had sensitivity of 97 and 90% and specificity of 59 and 66% with areas under the curve of 0.8506 and 0.8475, respectively, for women and men. We conclude that OSTA performed just as well or even better than other indices used in other populations to identify individuals who are at varying degrees of risk for osteoporosis. The tool also proves to be a useful and practical guide to help clinicians to be more prudent and judicious in employing bone mineral density measurement.