geoffrey modest medical blogs

  A recent meta-analysis confirmed that gout needs to be treated with anti-inflammatory meds for longer than three months   after initiating urate-lowering meds  in order to decrease the risk of a recurrent flare  (see   gout flares high after stopping prophy ArthCareRes2024  in dropbox, or DOI 10.1002/acr.25486)   Details: --researchers found 6 trials in the literature and one with aggregated unpublished data from the VA (the VA STOP Gout trial), with a total of 2972 participants     -- these trials were chosen because they had at least one study arm with starting or intensifying urate-lowering therapy (ULT) in which anti-inflammatory prophylaxis was prescribed; these included trials needed to report the percentage of participants with at least one gout flare both during and after the period of anti-inflammatory prophylaxis was  documented  -- trial durations ranged from 24 to 104 weeks, and anti-inflammatory prophylaxis durations ...

  A recent article evaluated serum uric acid levels in patients with known gout and their subsequent development of recurrent gout attacks (see   gout uric acid levels and recurrent gout JAMA2024  in dropbox, or doi:10.1001/jama.2023.26640)   Details : -- a retrospective study of 3613 patients aged 40 to 69 with a history of gout who were in the UK Biobank database and had a single serum uric acid level checked between 2006 and 2010, then followed until 2020 through the Primary Care Linked Data medical record linkage and the Hospital Episode Statistics databases -- 86% men, mean age 60, 99% white -- mean serum urate level 6.9 mg/dL, BMI 30, daily alcohol consumption 32%/no alcohol consumption 6%, current smokers 9%/former smokers 48%, coffee intake none in 23%/1 to 2 cups per day 40%/3 to 5 cups per day 23% -- red meat intake 4 servings per week, poultry intake 2 servings per week -- diuretic use at baseline 12%, uric acid lowering therapy at baseline ...