Treat-to-target (T2T) recommendations for gout

被引：149

作者：

Kiltz, U. ^{[1
,2
]}

Smolen, J. ^{[3
]}

Bardin, T. ^{[4
,5
]}

Solal, A. Cohen ^{[6
]}

Dalbeth, N. ^{[7
,8
]}

Doherty, M. ^{[9
]}

Engel, B. ^{[10
]}

Flader, C. ^{[1
,2
]}

Kay, J. ^{[11
,12
]}

Matsuoka, M. ^{[13
]}

Perez-Ruiz, F. ^{[14
]}

da Rocha Castelar-Pinheiro, G. ^{[15
]}

Saag, K. ^{[16
]}

So, A. ^{[17
,18
]}

Mellado, J. Vazquez ^{[19
]}

Weisman, M. ^{[20
]}

Westhoff, T. H. ^{[21
]}

Yamanaka, H. ^{[22
]}

Braun, J. ^{[1
,2
]}

机构：

[1] Rheumazentrum Ruhrgebiet, D-44652 Herne, Germany

[2] Rheumazentrum Ruhrgebiet, Herne, Germany

[3] Med Univ Vienna, Div Rheumatol, Dept Med 3, Vienna, Austria

[4] Univ Paris Diderot, Lariboisiere Hosp, AP HP, Sorbonne Paris Cite,Dept Rheumatol, Paris, France

[5] INSERM, UMR 1132, Paris, France

[6] Univ Paris VII Denis Diderot, Hop Lariboisiere, AP HP, INSERM,Serv Cardiol,Res Med Unit, Paris, France

[7] Univ Auckland, Auckland, New Zealand

[8] Auckland Dist Hlth Board, Auckland, New Zealand

[9] Univ Nottingham, Nottingham, England

[10] Univ Bonn, Inst Gen Practice & Family Med, Fac Med, Bonn, Germany

[11] UMass Mem Med Ctr, Worcester, MA USA

[12] Univ Massachusetts, Sch Med, Worcester, MA USA

[13] Carnegie Mellon Univ, Pittsburgh, PA 15213 USA

[14] Hosp Cruces, Div Rheumatol, Baracaldo, Vizcaya, Spain

[15] Univ Estado Rio De Janeiro, Discipline Rheumatol, Rio De Janeiro, Brazil

[16] Univ Alabama Birmingham, Birmingham, AL USA

[17] CHU Vaudois, Serv Rhumatol, Lausanne, Switzerland

[18] Univ Lausanne, Lausanne, Switzerland

[19] Hosp Gen Mexico City, Serv Reumatol, Mexico City, DF, Mexico

[20] UCLA, David Geffen Sch Med, Cedars Sinai Med Ctr, Div Rheumatol, Los Angeles, CA USA

[21] Ruhr Univ Bochum, Marien Hosp Herne, Dept Med 1, Herne, Germany

[22] Tokyo Womens Med Univ, Tokyo, Japan

来源：

ANNALS OF THE RHEUMATIC DISEASES | 2017年 / 76卷 / 04期

关键词：

SYSTEMATIC LITERATURE SEARCH; RANDOMIZED CONTROLLED-TRIALS; OF-RHEUMATOLOGY GUIDELINES; INTERNATIONAL TASK-FORCE; PSORIATIC-ARTHRITIS; SYNOVIAL-FLUID; TIGHT CONTROL; MANAGEMENT; DIAGNOSIS; HYPERURICEMIA;

D O I：

10.1136/annrheumdis-2016-209467

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objectives The treat-to-target (T2T) concept has been applied successfully in several inflammatory rheumatic diseases. Gout is a chronic disease with a high burden of pain and inflammation. Because the pathogenesis of gout is strongly related to serum urate levels, gout may be an ideal disease in which to apply a T2T approach. Our aim was to develop international T2T recommendations for patients with gout. Methods A committee of experts with experience in gout agreed upon potential targets and outcomes, which was the basis for the systematic literature search. Eleven rheumatologists, one cardiologist, one nephrologist, one general practitioner and one patient met in October 2015 to develop T2T recommendations based on the available scientific evidence. Levels of evidence, strength of recommendations and levels of agreement were derived. Results Although no randomised trial was identified in which a comparison with standard treatment or an evaluation of a T2T approach had been performed in patients with gout, indirect evidence was provided to focus on targets such as normalisation of serum urate levels. The expert group developed four overarching principles and nine T2T recommendations. They considered dissolution of crystals and prevention of flares to be fundamental; patient education, ensuring adherence to medications and monitoring of serum urate levels were also considered to be of major importance. Conclusions This is the first application of the T2T approach developed for gout. Since no publication reports a trial comparing treatment strategies for gout, highly credible overarching principles and level D expert recommendations were created and agreed upon.

引用

页码：632 / 638

页数：7

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