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    • Last Update: 2022-01-21
    • Source: Internet
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    The Asia Pacific League Against Rheumatism (APLAR) released the 2021 clinical practice guidelines for the treatment of gout


    The Asia Pacific League Against Rheumatism (APLAR) released the 2021 clinical practice guidelines for the treatment of gout


    Both guidelines for hyperuricemia in patients with gout and the overall guidance of the overall principle is similar, are referred to the importance of non-drug therapy, concerns related complications content and other aspects


    Importance of nonpharmacological treatment, concern for associated complications

     

    The treatment of asymptomatic hyperuricemia

     

    Regarding the drug treatment of patients with asymptomatic hyperuricemia, the guidelines of various countries have different opinions.


    The treatment of acute gout

     

    Scholars at home and abroad have suggested that uric acid-lowering therapy should be started after the acute attack of gout has been completely relieved


     

    4.


    The two guidelines for the anti-inflammatory and analgesic treatment of acute gout attacks are basically similar


     

    Five, uric acid lowering treatment

     

    For HLA-B*5801-positive patients, both guidelines do not recommend the use of allopurinol


     

    Six, the treatment of chronic tophi arthritis

     

    For patients with chronic tophi arthritis, a xanthine oxidase inhibitor (allopurinol or febuxostat) is recommended to dissolve tophi rather than no urate-lowering therapy (strong/low)


    In chronic tophi arthritis patients with serum uric acid level >6 mg/dL, the addition of a novel uric acid-lowering drug RDEA594 (lesinurad) to the treatment of xanthine oxidase inhibitors for tophi dissolution is not recommended (weak/moderate)


    The "Chinese Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout (2019)" does not mention the treatment of chronic tophi arthritis

    7.


     

    The use of lesinurad is not mentioned in the Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout in China (2019), but it is mentioned in the Guidelines for Diagnosis and Treatment of Gout (2020) that lesinurad can be used for a single and sufficient dose of xanthine oxidase inhibitors.


     

    8.


     

    9.


    The two guidelines disagree on a high-purine diet


    references:

    【1】.


    【2】.
    Lorenzo JPP, Sollano MHMZ, Salido EO,et al.
    2021 Asia-Pacific League of Associations for Rheumatology clinical practice guideline for treatment of gout[J].
    Int J Rheum Dis.
    2021 Dec 20.
     

    【3】.
    Xu Dong, Zhu Xiaoxia, Zeng Xuejun, et al.
    Standard of gout diagnosis and treatment[J].
    Chinese Journal of Internal Medicine, 2020(6).



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