International journal of rheumatic diseases · 2025
2024 Update of Chinese Guidelines for Management of Hyperuricemia and Gout Part II: Recommendations for Patients With Common Comorbidities.
СтатьяКлинические рекомендацииНазвание и аннотация: Перевод в очереди
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Li Changgui, Sun Mingshu, Liu Zhen, Li Detian, Wang Changqian, Tian Zibin, Dai Yuxiang, Feng Zhe, Xu Chengfu, Zhao Dongbao, Wei Feng, Ban Bo, Xie Chao, An Zhenmei, Liu Jia, Li Zhuo, He Yuwei, Li Xinde, Yan Fei, Han Lin, Ma Lidan, Cheng Xiaoyu, Liu Tian, Luo Xufei, Cui Lingling, Gong Ying, Wang Can, Chen Yaolong, Lyu Zhaohui, Yip Ronald M L, Zhao Jiajun
Аннотация
OBJECTIVE: The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease (CKD), cardiovascular disease (CVD), diabetes, osteoarthritis (OA), and gastrointestinal disorders.
METHODS: This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO (population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus.
RESULTS: The guideline presents 26 evidence-based recommendations addressing seven clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage ≥ 3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases, and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases.
CONCLUSION: The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.
METHODS: This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO (population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus.
RESULTS: The guideline presents 26 evidence-based recommendations addressing seven clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage ≥ 3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases, and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases.
CONCLUSION: The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.