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Italian Society of Rheumatology recommendations for the management of gout

M. Manara, A. Bortoluzzi, M. Favero, I. Prevete, C.A. Scirè, G. Bianchi, C. Borghi, M. A. Cimmino, G. M. D'Avola, G. Desideri, G. Di Giacinto, M. Govoni, W. Grassi, A. Lombardi, M. Marangella, M. Matucci Cerinic, G. Medea, R. Ramonda, A. Spadaro, L. Punzi, G. Minisola
  • A. Bortoluzzi
    Rheumatology Unit, Department of Clinical and Experimental Medicine, Ferrara University, Italy
  • M. Favero
    Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
  • I. Prevete
    Rheumatology Unit, S. Camillo Hospital, Roma, Italy
  • C.A. Scirè
    Epidemiology Unit, Italian Society of Rheumatology (SIR), Milano, Italy
  • G. Bianchi
    Rheumatology Unit, Azienda Sanitaria Locale 3, Genova, Italy
  • C. Borghi
    Department of Internal Medicine, University of Bologna, Bologna, Italian Society for Cardiovascular Disease Prevention (SIPREC), Italy
  • M. A. Cimmino
    Rheumatology Clinic, Department of Internal Medicine, University of Genova, Genova, Italy
  • G. M. D'Avola
    Rheumatology and Osteoporosis Service, ASP 3, Catania, Italy
  • G. Desideri
    Geriatric Unit, Department of Life, Health, and Environmental Sciences, University of L’Aquila, L’Aquila, Italy; Italian Society of Gerontology and Geriatrics (SIGG), Italy
  • G. Di Giacinto
    General practitioner, ASUR Marche, Urbino, Italy; Italian Interdisciplinary Society for Primary Care (SIICP), Italy
  • M. Govoni
    Rheumatology Unit, Department of Clinical and Experimental Medicine, Ferrara University, St. Anna University Hospital, Ferrara, Italy
  • W. Grassi
    Rheumatology Clinic, Università Politecnica delle Marche, Jesi, Ancona, Italy
  • A. Lombardi
    General practitioner, ASL 10 Firenze, Italy; METIS Scientific Association of Italian Family Doctors, Italy
  • M. Marangella
    Nephrology Unit, Mauriziano Hospital, Torino; Italian Society of Nephrology (SIN), Italy
  • M. Matucci Cerinic
    Department of Biomedicine, Division of Rheumatology A.O.U.C., Department of Medicine, Denothe Centre, University of Florence, Florence, Italy
  • G. Medea
    General practitioner, Brescia, Italy; Italian Society of General Medicine (SIMG), Italy
  • R. Ramonda
    Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
  • A. Spadaro
    Clinical and Medical Therapy Department, Rheumatology Unit, La Sapienza University, Rome, Italy
  • L. Punzi
    Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova,
  • G. Minisola
    Rheumatology Unit, S. Camillo Hospital, Roma, Italy

Abstract

Objective: Gout is the most common arthritis in adults. Despite the availability of valid therapeutic options, the management of patients with gout is still suboptimal. The Italian Society of Rheumatology (SIR) aimed to update, adapt to national contest and disseminate the 2006 EULAR recommendations for the management of gout.
Methods: The multidisciplinary group of experts included rheumatologists, general practitioners, internists, geriatricians, nephrologists, cardiologists and evidence-based medicine experts. To maintain consistency with EULAR recommendations, a similar methodology was utilized by the Italian group. The original propositions were translated in Italian and priority research queries were identified through a Delphi consensus approach. A systematic search was conducted for selected queries. Efficacy and safety data on drugs reported in RCTs were combined in a meta-analysis where feasible. The strength of recommendation was measured by utilising the EULAR ordinal and visual analogue scales.
Results: The original 12 propositions were translated and adapted to Italian context. Further evidences were collected about the role of diet in the non-pharmacological treatment of gout and the efficacy of oral corticosteroids and low-dose colchicine in the management of acute attacks. Statements concerning uricosuric treatments were withdrawn and replaced with a proposition focused on a new urate lowering agent, febuxostat. A research agenda was developed to identify topics still not adequately investigated concerning the management of gout.
Conclusions: The SIR has developed updated recommendations for the management of gout adapted to the Italian healthcare system. Their implementation in clinical practice is expected to improve the management of patients with gout.

Keywords

Gout, treatment, recommendations.

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Submitted: 2013-02-24 15:02:07
Published: 2013-03-28 18:43:14
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Copyright (c) 2013 M. Manara, A. Bortoluzzi, M. Favero, I. Prevete, C.A. Scirè, G. Bianchi, C. Borghi, M. A. Cimmino, G. M. D'Avola, G. Desideri, G. Di Giacinto, M. Govoni, W. Grassi, A. Lombardi, M. Marangella, M. Matucci Cerinic, G. Medea, R. Ramonda, A. Spadaro, L. Punzi, G. Minisola

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