Gouty Arthritis in Acute Cerebrovascular Disease

Lin, Ya-Hui; Hsu, Huan-Lin; Huang, Ying‐Chih; Lee, Meng; Huang, Wen‐Yi; Huang, Yen-Chu; Lee, Tsong‐Hai; Lee, Jiann-Der

doi:10.1159/000235626

Cited by 23 publications

(13 citation statements)

References 77 publications

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“…Gouty arthritis can also add to hospital time for patients with other illnesses. Lin et al documented that a gouty arthritis attack in patients hospitalized for cerebrovascular disease increased the hospital time by more than 3 days (). Anakinra is expensive; however, its cost may be offset by reducing the need for hospitalization and/or length of stay for inpatients with gouty arthritis.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Acute Gouty Arthritis in Complex Hospitalized Patients With Anakinra

Ghosh

Cho

Rawat

et al. 2013

Arthritis Care & Research

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Objective. To report our experience with the efficacy and safety of anakinra for acute gouty arthritis in medically complex hospitalized patients. Methods. We reviewed the hospital charts of 26 patients treated with anakinra for crystal-induced arthritis since 2007. Demographics, comorbid conditions, reason for anakinra use, response to treatment, and any adverse outcomes were recorded. Results. Twenty-six patients received 40 courses of anakinra therapy. In 67% of patients, pain improved significantly within 24 hours, and complete resolution of signs and symptoms of gout occurred by day 5 in 72.5% of patients. Seven patients received multiple courses with no decrement in response with repeated treatments. Anakinra was well tolerated and no adverse outcomes were attributed to the medication. Only 1 patient appeared to be refractory to this form of interleukin-1 inhibition. Conclusion. Anakinra is an effective and safe alternative treatment for acute gouty arthritis in medically complex hospitalized patients who fail or cannot undergo more conventional therapy.

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Section: Discussionmentioning

confidence: 99%

Treatment of Acute Gouty Arthritis in Complex Hospitalized Patients With Anakinra

Ghosh

Cho

Rawat

et al. 2013

Arthritis Care & Research

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“…Gout is a common disease as a consequence of hyperuricemia which increases the risks of hypertension [6, 12], cardiovascular diseases [13], cerebrovascular diseases [14], and renal failure [15]. Previous studies identified several transporter genes associated with gout, such as ATP-binding cassette transporter, subfamily G, member 2 ( ABCG2/BCRP ) [11, 16–18], GLUT9/SLC2A9 [19–21], monocarboxylate transporter 9 ( MCT9/SLC16A9 ) [22], and organic anion transporter 4 ( OAT4/SLC22A11 ) [23].…”

Section: Discussionmentioning

confidence: 99%

A common variant of leucine-rich repeat-containing 16A (LRRC16A) gene is associated with gout susceptibility

et al. 2013

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Gout is a common disease resulting from hyperuricemia which causes acute arthritis. Recently, genome-wide association studies revealed an association between serum uric acid levels and a common variant of leucine-rich repeat-containing 16A (LRRC16A) gene. However, it remains to be clarified whether LRRC16A contributes to the susceptibility to gout. In this study, we investigated the relationship between rs742132 in LRRC16A and gout. A total of 545 Japanese male gout cases and 1,115 male individuals as a control group were genotyped. rs742132 A/A genotype significantly increased the risk of gout, conferring an odds ratio of 1.30 (95 % CI 1.05–1.60; p = 0.015). LRRC16A encodes a protein called capping protein ARP2/3 and myosin-I linker (CARMIL), which serves as an inhibitor of the actin capping protein (CP). CP is an essential element of the actin cytoskeleton, which binds to the barbed end of the actin filament and regulates its polymerization. In the apical membrane of proximal tubular cells in the human kidney, the urate-transporting multimolecular complex (urate transportsome) is proposed to consist of several urate transporters and scaffolding proteins, which interact with the actin cytoskeleton. Thus, if there is a CARMIL dysfunction and regulatory disability in actin polymerization, urate transportsome may be unable to operate appropriately. We have shown for the first time that CARMIL/LRRC16A was associated with gout, which could be due to urate transportsome failure.Electronic supplementary materialThe online version of this article (doi:10.1007/s13577-013-0081-8) contains supplementary material, which is available to authorized users.

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“…These findings are noteworthy because up to 18% of gout patients are hospitalized each year (all causes), making hospitalization an important potential exposure at the population level. 4 Because gout attacks have the potential to prolong hospital stay, 8 there is great potential to reduce healthcare costs by treating hospitalized patients with pre-existing gout with prophylactic medications, if our findings are replicated in other studies.…”

Section: Discussionmentioning

confidence: 64%

Increased Risk of Recurrent Gout Attacks with Hospitalization

Dubreuil

Neogi

Chen

et al. 2013

The American Journal of Medicine

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Background While anecdotal evidence suggests that risk of recurrent gout attack increases with hospitalization, no study has formally tested this hypothesis. Methods We conducted an online case-crossover study of individuals with gout. We obtained information on gout attacks over a one-year period, including: onset date, symptoms and signs, medications, and exposure to potential risk factors, including hospitalization, during the 2-day hazard period prior to each gout attack. The same exposure information was also obtained over 2-day intercritical gout control periods. We performed conditional logistic regression to examine the relationship of hospitalization with recurrent gout attacks and whether such a relationship was modified by concomitant use of anti-gout medications. Results Of 724 participants (mean age 54.5 years, 78.5% male), 35 hospitalizations occurred during either a hazard or control period. The adjusted odds of gout attacks was increased 4-fold with hospitalization (OR 4.05, 95% confidence interval: 1.78–9.19) compared with no hospitalization. The effect of hospitalization tended to attenuate with use of allopurinol, colchicine, or NSAIDs, but not statistically significantly. Conclusions Our study confirmed that the risk of gout attacks increases among gout patients during hospitalization. Appropriate measures should be considered for prevention of gout attacks during hospitalization for patients with pre-existing gout.

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Gouty Arthritis in Acute Cerebrovascular Disease

Cited by 23 publications

References 77 publications

Treatment of Acute Gouty Arthritis in Complex Hospitalized Patients With Anakinra

Treatment of Acute Gouty Arthritis in Complex Hospitalized Patients With Anakinra

A common variant of leucine-rich repeat-containing 16A (LRRC16A) gene is associated with gout susceptibility

Increased Risk of Recurrent Gout Attacks with Hospitalization

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