🫶🫶🫶

Gout goes beyond joints.
Dr. Jasvinder Singh presents data linking gout to higher risks of myocardial infarction, vascular events, and atrial fibrillation, even when accounting for common comorbidities.
Emerging evidence reinforces gout as a systemic disease impacting cardiovascular health. #ACR25

@natalie-mccor.bsky.social summarized that over half of people with gout also have metabolic syndrome, with insulin resistance driving hyperuricemia through reduced renal excretion. Lifestyle changes like weight loss and lower fructose intake can improve both gout and metabolic outcomes. #ACR25

Dr. Natalie McCormick adds how insulin resistance drives gout via decreased renal urate clearance. Elevated insulin enhances urate reabsorption through URAT1 and other transporters, linking metabolic dysfunction to hyperuricemia and gout risk. #ACR25

Dr. Natalie McCormick discusses how insulin resistance drives gout through both urate overproduction and underexcretion. Fructose intake plays a key role, rapidly increasing uric acid synthesis and gout risk with higher dietary consumption. #Gout #MetabolicSyndrome #ACR25

Dr. Natalie McCormick highlights that serum urate levels are strongly linked to metabolic syndrome burden. Hyperuricemia may serve as a surrogate marker of metabolic risk, suggesting urate could be considered a 6th MetS criterion. #ACR25

Live from #ACR25- Dr. Natalie McCormick is discussing the link between metabolic syndrome and gout, highlighting how insulin resistance and inflammation contribute to disease burden and outcomes.

Okay, only if you bring me a bracelet!

But is this an open invite? 😹

Dr. Angelo Gaffo emphasized that gout diagnosis relies on clinical presentation, serum urate, and imaging when available. Crystal confirmation is ideal but not always required. Context and tools matter. #ACR25 #gout #rheumatology

At #ACR25, Dr. Angelo Gaffo emphasized that serum urate can guide gout diagnosis, but timing matters. Levels often decrease during acute flares, underscoring the need for clinical context in interpreting sUA. #Gout #Rheumatology

Can I have one?!

Dr. Tim Kwok emphasized that “difficult-to-treat gout” goes beyond urate levels, involving persistent inflammation, reduced function, and higher healthcare use. A holistic approach addressing clinical, patient, and system factors is key. #2025GCAN #Gout #Rheumatology

EULAR D2T RA 2019 ASAS difficult to manage axSpA 2025 GRAPPA D2T PsA in progress GCAN D2T gout proposal

Tim Kwok @uoftrheum.bsky.social on D2T gout, focusing on equity and who needs to get uricase based therapies

The D2T concept started with RA, has taken hold of axSpA and PsA, and now gout enters the chat

#GCAN2025 #ACR25

Throwback 🧢 #GCAN2023

BUT CLOAK, a colchicine in knee OA RCT was negative.

Are we asking the wrong Q? Do we need a long duration on colchicine to detect tx benefit?

LoDoCo2 posthoc: colchicine reduced risk of jt replacement

#GCAN2025 #ACR25

OA & gout: both related to chronic low level inflammation thru IL-1b

Urate levels have been a/w OA progression & higher synovial fluid IL-1b levels in OA knees

Is there benefit of colchicine in knee OA?

#GCAN2025 #ACR25

Dr. Michael Pillinger: Colchicine continues to show potential CV benefits in gout. Cipolletta et al. found lower short-term MI/stroke risk with colchicine during ULT initiation (HR 0.72). Yokose et al. showed colchicine safer than NSAIDs, though not vs placebo.
#2025GCAN #Gout #Cardiology

⭐Ben Hemming - UAB

More on gout & CVD: recurrent MSU crystal injection induces macrophage protective tolerance. Studied in vivo (mice) and in vitro.

#GCAN2025 #ACR25

⭐Daniel Ward Phillips - UAB

Focus on gout & CVD: how does inflammation from MSU crystals cause ASCVD?

Studied in mice: fed a Western diet and injected with MSU crystals

Unique inflam response from EMP1+ macrophage-like monocytes

#GCAN2025 #ACR25

Dr. Jason Yang: In STOP Gout, achieving SU < 6 mg/dL was linked to flares with lower pain intensity and shorter duration (esp. in pts w/o tophi). Flare characteristics may serve as early indicators of ULT efficacy beyond flare counts.
#2025GCAN #Gout #Rheumatology

In the STOP Gout trial, 77% of pts achieved SU <6 mg/dL at or below the EasyAllo2-predicted allopurinol dose. Younger age, lower eGFR, and higher SU required higher doses, supporting EasyAllo2 for guided dose escalation.
Dr. Brian Coburn #2025GCAN #Gout #Rheumatology

Dr. Hyon Choi presents new data supporting treat-to-target urate lowering in gout.
In a 10-year cohort (n=3,613), 95% of flares occurred with SU ≥6 mg/dL and 98% with SU ≥5 mg/dL. Flare rates rose sharply as SU increased, reinforcing the <6 mg/dL goal.
#2025GCAN #Gout #Rheumatology

the title slide with yellow text on blue background

Dr Hyon Choi (MGH Boston) #GCAN2025 on T2T ULT pragmatic trials in gout

#ACR25

AI is advancing crystal disease diagnosis.
Deep learning models can now detect CPPD on hand radiographs, and machine learning of Raman spectra enables point-of-care identification of gout and CPPD.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology #AIinMedicine

In a national VA cohort (18,761 CPPD pts, 75,043 controls), nephrolithiasis prevalence was higher in CPPD (8.6% vs 5.1%). Adjusted OR 1.65 supports CPPD as an independent risk factor for kidney stones and a systemic mineralization disorder.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

In >20,000 matched patients aged ≥60, CPPD was linked to a 29% higher risk of any fracture across spine and limb sites over 85,000 patient-years. Risk was consistent in both men and women, supporting bone health screening in CPPD.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

In a Mass General Brigham cohort (1991–2022), 756 CPPD patients had higher 10-year ASCVD risk scores vs matched controls, despite similar CAC burden. Findings suggest factors beyond CAC contribute to elevated CV risk in CPPD.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

From 20-year and 7-year cohort data, chondrocalcinosis was present in 5% at baseline and linked to higher odds of incident knee OA (OR 1.75). No consistent association with knee pain. CC may represent a distinct OA subtype.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology