New ACR Gout Guidelines: What's Missing, What's New

The American College of Rheumatology has issued new guidelines on the treatment of hyperuricemia and acute gouty arthritis. In this podcast, the head of the guidelines panel, John Fitzgerald MD, the lead investigator of the guidelines process, discusses important issues surrounding the guidelines, including perspectives on treating to target and the impact on referrals.

Dr. Fitzgerald is acting chief of the rheumatology division at the University of California Los Angeles.

Questions:

1. Anybody can look up the guidelines and read them in full. What are some of the limitations of the guidelines and what did they not say?

2. We have all learned about the importance of treat to target. The guidelines give a little latitude about what the target should be. Can you give a little guidance on how to make that decision and when?

3. The guidelines mention using an HLA-B marker to test for a tendency to adverse reactions to allopurinol(Drug information on allopurinol). Can you tell us a little more about who needs that test?

4. What do you think is going to be the impact on referrals to rheumatologists?
 

For your reference:

Khanna D, Fitzgerald JD, Khanna PP et al. (2012) 2012 American College of Rheumatology guidelines for management of gout. Part 1: Systematic nonpharmacologic and pharmacologic therapeutic approaches to hyperuricemia
Arthritis Care & Research 64(10):1431–1446

 

Khanna D, Khanna PP, Fitzgerald JD et al. (2012) 2012 American College of Rheumatology guidelines for management of gout. Part 2: Therapy and antiinflammatory prophylaxis of acute gouty arthritis
Arthritis Care & Research 64(10):1447–1461