Management of acute and recurrent gout: A clinical practice guideline from the American College of Physicians

Clinical Guidelines Committee of the American College of Physicians

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on the management of gout. Methods: Using the ACP grading system, the committee based these recommendations on a systematic review of randomized, controlled trials; systematic reviews; and large observational studies published between January 2010 and March 2016. Clinical outcomes evaluated included pain, joint swelling and tenderness, activities of daily living, patient global assessment, recurrence, intermediate outcomes of serum urate levels, and harms. Target Audience and Patient Population: The target audience for this guideline includes all clinicians, and the target patient population includes adults with acute or recurrent gout. Recommendation 1: ACP recommends that clinicians choose corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs), or colchicine to treat patients with acute gout. (Grade: strong recommendation, high-quality evidence) Recommendation 2: ACP recommends that clinicians use low-dose colchicine when using colchicine to treat acute gout. (Grade: strong recommendation, moderate-quality evidence) Recommendation 3: ACP recommends against initiating longterm urate-lowering therapy in most patients after a first gout attack or in patients with infrequent attacks. (Grade: strong recommendation, moderate-quality evidence) Recommendation 4: ACP recommends that clinicians discuss benefits, harms, costs, and individual preferences with patients before initiating urate-lowering therapy, including concomitant prophylaxis, in patients with recurrent gout attacks. (Grade: strong recommendation, moderate-quality evidence)

Original languageEnglish (US)
Pages (from-to)58-68
Number of pages11
JournalAnnals of Internal Medicine
Volume166
Issue number1
DOIs
StatePublished - Jan 3 2017

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Gout
Practice Guidelines
Physicians
Colchicine
Uric Acid
Health Services Needs and Demand
Guidelines
Patient Preference
Arthralgia
Activities of Daily Living
Cost-Benefit Analysis
Observational Studies
Adrenal Cortex Hormones
Anti-Inflammatory Agents
Randomized Controlled Trials
Recurrence
Therapeutics
Serum
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Internal Medicine

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Management of acute and recurrent gout : A clinical practice guideline from the American College of Physicians. / Clinical Guidelines Committee of the American College of Physicians.

In: Annals of Internal Medicine, Vol. 166, No. 1, 03.01.2017, p. 58-68.

Research output: Contribution to journalArticle

Clinical Guidelines Committee of the American College of Physicians. / Management of acute and recurrent gout : A clinical practice guideline from the American College of Physicians. In: Annals of Internal Medicine. 2017 ; Vol. 166, No. 1. pp. 58-68.
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