Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout

Abstract

ObjectiveThere is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.MethodsA content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.ResultsThe content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: ‘asymptomatic hyperuricaemia’, ‘asymptomatic monosodium urate crystal deposition’, ‘asymptomatic hyperuricaemia with monosodium urate crystal deposition’, ‘gout’, ‘tophaceous gout’, ‘erosive gout’, ‘first gout flare’ and ‘recurrent gout flares’. There was consensus agreement that the label ‘gout’ should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).ConclusionConsensus agreement has been established for the labels and definitions of eight gout disease states, including ‘gout’ itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

Prevalence, Incidence, and Years Lived With Disability Due to Gout and Its Attributable Risk Factors for 195 Countries and Territories 1990–2017: A Systematic Analysis of the Global Burden of Disease Study 2017

“…The disease is described as inflammation caused by the formation of monosodium urate (MSU) crystals in the synovial fluid of joints and other tissues (2). In 2019, the Gout, Hyperuricemia and Crystal‐Associated Disease Network published a consensus agreement for the labels and definitions of 11 elements representing the fundamental components of gout etiology, pathophysiology, and clinical presentation (3,4). The painful condition characteristically presents with peripheral joint flares with eventual development of joint damage, as well as deformity and subcutaneous tophus deposition (5).…”

Time to recognise gout as a chronic disease

“…3 The chronic nature of the disease is reflected in the current definition of gout as "current or prior clinically evident disease", as agreed by international gout experts. 4 Gout is a systemic disease and an established independent risk factor for renal and cardiovascular disease. Like many chronic diseases, flares of gout and their long term consequences can be prevented with daily medication.…”

“…Many people with gout have not received this information from their health care providers and view the disease as present only when they are experiencing a flare . The chronic nature of the disease is reflected in the current definition of gout as “current or prior clinically evident disease”, as agreed by international gout experts . Gout is a systemic disease and an established independent risk factor for renal and cardiovascular disease.…”

Differences in Achilles tendon stiffness in people with gout.

“…The terminology used for gout used in the paper follows the G-CAN consensus statements. [27] In this cross sectional, case-controlled study, participants with gout were recruited from an out-patient podiatry clinic in East Sussex. Ethical approval was granted by the University of Brighton (17-009) and O ce for Research Ethics Committees Northern Ireland (ORECNI) (232339).…”