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
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
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
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
In 51 patients with OA, ultrasound outperformed radiography for detecting CPPD (accuracy 0.78 vs 0.73). Combining both modalities added value only in select cases. US alone was more reliable for CPPD identification.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology
In a community cohort of 861, knee US detected calcium crystals in 13% of cases, linked to over 50% higher odds of moderate/severe pain and 60% higher odds of radiographic KOA. US-based diagnosis shows promise for broader KOA assessment.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology
Hip ultrasound shows strong accuracy for detecting CPPD.
In 100 hip replacement patients, US sensitivity was 90%, specificity 82%, and AUC 0.86 compared with histopathology, supporting US as a reliable tool for hip CPPD detection.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology
The largest gout GWAS to date (2.6M people, 120k gout cases) identified 377 loci (149 new), including 22 linked to gout inflammation independent of urate. Pathways span cytokine signaling, epigenetic remodeling, and CHIP (TET2) with causal links to gout.
– Dr. Isidoro Cobo #2025GCAN
The burden of gout flares remains high.
Patients averaged 6.6 flares per year, and 72% of flares were unreported, pretreated, or prevented, highlighting major underrecognition of disease activity.
– Dr. Edoardo Cipolletta #2025GCAN #GoutAwareness #Rheumatology
AI in managing gout
In a 4-yr study of 2,670 pts, an AI-based gout management system led to lower CKD stage ≥3 incidence (HR 0.57) and higher SU goal attainment (49.8% vs 25.9%) vs standard care.
– Dr. Edoardo Cipolletta #2025GCAN #Rheumatology #GoutAwareness
In 2025, Gout remains undertreated.
Among gout+CKD pts starting ULT, only 48.3% had SU checked in 6mo & 54.3% had no dose change.
In hospitalized pts, SU measured in 16.3%; 43.1% >target; 80% had dose unchanged/reduced.
– Dr. Edoardo Cipolletta #2025GCAN #GoutAwareness
