Подагра. Новые возможности диагностики и лечения
Подагра. Новые возможности диагностики и лечения
Материалы доступны только для специалистов сферы здравоохранения. Авторизуйтесь или зарегистрируйтесь.
Аннотация
Заболеваемость подагрой увеличивается в последние годы. Несмотря на современные диагностические возможности, врачи встречаются с трудностями при постановке этого диагноза. Европейская Антиревматическая Лига (EULAR) и Американский колледж ревматологов (ACR) в 2015 г. разработали новые критерии диагностики подагры. В 2016 г. экспертной группой EULAR предложена стратегия лечения пациентов с этим заболеванием. В статье представлены основные положения этой стратегии, а также новые исследования, позволяющие определить наиболее эффективные и безопасные возможности терапии этого заболевания.
Ключевые слова: подагра, критерии диагноза, немедикаментозная и медикаментозная терапия, бессимптомная гиперурикемия.
Keywords: gout, diagnostic criteria, non-drug and medication therapy, asymptomatic hyperuricemia.
Ключевые слова: подагра, критерии диагноза, немедикаментозная и медикаментозная терапия, бессимптомная гиперурикемия.
________________________________________________
Keywords: gout, diagnostic criteria, non-drug and medication therapy, asymptomatic hyperuricemia.
Список литературы
1. Neogi T, Jansen T, Dalbeth N et al. 2015 Gout classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2015; 74(10):1789-98.
2. Amir Qaseem MD, PhD MHA, Russell P, Harris MD MPH, Mary Ann Forciea MD; for the 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. Ann Intern Med. 2017; 166(1):58-68.
3. Richette P et al. 2016 updated EULAR evidence-based recommendations for the management of gout. 2016; 0:1-14.
4. Nielsen SM et al. Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies. Ann Rheum Dis. 2017; 76:1870-1882.
5. Larsson SC, Carlström M. Coffee consumption and gout: a Mendelian randomisation study. Ann Rheum Dis. 2018 Feb 28. pii: annrheumdis-2018-213055. doi: 10.1136/annrheumdis-2018-213055
6. Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017 Jul 3;15(1):123.
7. Lytvyn Y, Skrtic M, Yang GK, Yip PM, Perkins BA, Cherney DZ. Glycosuria-mediated urinary uric acid excretion in patients with uncomplicated type 1 diabetes mellitus. Am J Physiol Renal Physiol. 2015; 308(2): 77-83.
8. Chen W, Liu X, Ye S. Effects of metformin on blood and urine pro-inflammatory mediators in patients with type 2 diabetes. J Inflamm (Lond). 2016; 13:34.
9. Roughley MJ, Belcher J, Mallen CD, Roddy E. Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies. Arthritis Res Ther. 2015; 17(1):90.
10. Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014; 15:122.
11. Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi H. Low-dose aspirin use and recurrent gout attacks. Ann Rheum Dis. 2014; 73(2):385-90.
12. Jasvinder A Singh. Role of serum urate in neurocognitive function and dementia: new evidence contradicts old thinking. Ann Rheum Dis. 2018; 77:317-318.
13. http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid= 762a33a0-a24f-4ab8-befb-ec80073eb972&t=5a047573-cbf8-4d63-a01d-b9b86afe9824
14. https://www.drugs.com/drug-interactions/allopurinol-index.html?filter=3&generic_only=
15. Frampton JE. Febuxostat: a review of its use in the treatment of hyperuricaemia in patients with gout. Drugs. 2015; 75(4):427-38.
16. Chou HY, Chen CB, Cheng CY, Chen YA, Ng CY, Kuo KL. Febuxostat-associated drug reaction with eosinophilia and systemic symptoms (DRESS). J Clin Pharm Ther. 2015; 40(6):689-692.
17. https://www.drugs.com/drug-interactions/febuxostat-index.html?filter=3&generic_only=
18. Roddy E, Packham J, Obrenovic K, Rivett A, Ledingham JM. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology (Oxford). 2018 Feb 13. doi: 10.1093/rheumatology/kex521
19. Dalbeth N, Phipps-Green A,Frampton C, Neogi T, Taylor WJ, Merriman TR. Relationship between serum urate concentrationand clinically evident incident gout: an individualparticipant data analysis. Ann Rheum Dis. 2018;0:1-5. doi:10.1136/annrheumdis-2017-212288
20. Eleftheriadis T, Golphinopoulos S, Pissas G, Stefanidis I. Asympto-matic hyperuricemia and chronic kidney disease: Narrative review of a treatmentcontroversial. J Adv Res. 2017; 8(5):555-560.
21. Sircar D, Chatterjee S, Waikhom R, Golay V, Raychaudhury A, Chatterjee S et al. Efficacy of febuxostat for slowing the GFR decline in patients with CKD and asymptomatic hyperuricemia: a 6-month, double-blind, randomized, placebo-controlled trial. Am J Kidney Dis. 2015; 66: 945-950.
22. Maria Erika G. Ramirez, Joanne M Bargman. Treatment of asymptomatic hyperuricemia in chronic kidney disease: A new target in an old enemy – A review. J Adv Res. 2017 Sep; 8(5): 551-554.
23. Hosoya T, Kimura K, Itoh S, Inaba M, Uchida S, Tomino Y et al.The effect of febuxostat to prevent a further reduction in renal function of patients with hyperuricemia who have never had gout and are complicated by chronic kidney disease stage 3: study protocol for a multicenter randomized controlled study. Trials. 2014; 15: 26.
2. Amir Qaseem MD, PhD MHA, Russell P, Harris MD MPH, Mary Ann Forciea MD; for the 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. Ann Intern Med. 2017; 166(1):58-68.
3. Richette P et al. 2016 updated EULAR evidence-based recommendations for the management of gout. 2016; 0:1-14.
4. Nielsen SM et al. Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies. Ann Rheum Dis. 2017; 76:1870-1882.
5. Larsson SC, Carlström M. Coffee consumption and gout: a Mendelian randomisation study. Ann Rheum Dis. 2018 Feb 28. pii: annrheumdis-2018-213055. doi: 10.1136/annrheumdis-2018-213055
6. Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017 Jul 3;15(1):123.
7. Lytvyn Y, Skrtic M, Yang GK, Yip PM, Perkins BA, Cherney DZ. Glycosuria-mediated urinary uric acid excretion in patients with uncomplicated type 1 diabetes mellitus. Am J Physiol Renal Physiol. 2015; 308(2): 77-83.
8. Chen W, Liu X, Ye S. Effects of metformin on blood and urine pro-inflammatory mediators in patients with type 2 diabetes. J Inflamm (Lond). 2016; 13:34.
9. Roughley MJ, Belcher J, Mallen CD, Roddy E. Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies. Arthritis Res Ther. 2015; 17(1):90.
10. Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014; 15:122.
11. Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi H. Low-dose aspirin use and recurrent gout attacks. Ann Rheum Dis. 2014; 73(2):385-90.
12. Jasvinder A Singh. Role of serum urate in neurocognitive function and dementia: new evidence contradicts old thinking. Ann Rheum Dis. 2018; 77:317-318.
13. http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid= 762a33a0-a24f-4ab8-befb-ec80073eb972&t=5a047573-cbf8-4d63-a01d-b9b86afe9824
14. https://www.drugs.com/drug-interactions/allopurinol-index.html?filter=3&generic_only=
15. Frampton JE. Febuxostat: a review of its use in the treatment of hyperuricaemia in patients with gout. Drugs. 2015; 75(4):427-38.
16. Chou HY, Chen CB, Cheng CY, Chen YA, Ng CY, Kuo KL. Febuxostat-associated drug reaction with eosinophilia and systemic symptoms (DRESS). J Clin Pharm Ther. 2015; 40(6):689-692.
17. https://www.drugs.com/drug-interactions/febuxostat-index.html?filter=3&generic_only=
18. Roddy E, Packham J, Obrenovic K, Rivett A, Ledingham JM. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology (Oxford). 2018 Feb 13. doi: 10.1093/rheumatology/kex521
19. Dalbeth N, Phipps-Green A,Frampton C, Neogi T, Taylor WJ, Merriman TR. Relationship between serum urate concentrationand clinically evident incident gout: an individualparticipant data analysis. Ann Rheum Dis. 2018;0:1-5. doi:10.1136/annrheumdis-2017-212288
20. Eleftheriadis T, Golphinopoulos S, Pissas G, Stefanidis I. Asympto-matic hyperuricemia and chronic kidney disease: Narrative review of a treatmentcontroversial. J Adv Res. 2017; 8(5):555-560.
21. Sircar D, Chatterjee S, Waikhom R, Golay V, Raychaudhury A, Chatterjee S et al. Efficacy of febuxostat for slowing the GFR decline in patients with CKD and asymptomatic hyperuricemia: a 6-month, double-blind, randomized, placebo-controlled trial. Am J Kidney Dis. 2015; 66: 945-950.
22. Maria Erika G. Ramirez, Joanne M Bargman. Treatment of asymptomatic hyperuricemia in chronic kidney disease: A new target in an old enemy – A review. J Adv Res. 2017 Sep; 8(5): 551-554.
23. Hosoya T, Kimura K, Itoh S, Inaba M, Uchida S, Tomino Y et al.The effect of febuxostat to prevent a further reduction in renal function of patients with hyperuricemia who have never had gout and are complicated by chronic kidney disease stage 3: study protocol for a multicenter randomized controlled study. Trials. 2014; 15: 26.
2. Amir Qaseem MD, PhD MHA, Russell P, Harris MD MPH, Mary Ann Forciea MD; for the 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. Ann Intern Med. 2017; 166(1):58-68.
3. Richette P et al. 2016 updated EULAR evidence-based recommendations for the management of gout. 2016; 0:1-14.
4. Nielsen SM et al. Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies. Ann Rheum Dis. 2017; 76:1870-1882.
5. Larsson SC, Carlström M. Coffee consumption and gout: a Mendelian randomisation study. Ann Rheum Dis. 2018 Feb 28. pii: annrheumdis-2018-213055. doi: 10.1136/annrheumdis-2018-213055
6. Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017 Jul 3;15(1):123.
7. Lytvyn Y, Skrtic M, Yang GK, Yip PM, Perkins BA, Cherney DZ. Glycosuria-mediated urinary uric acid excretion in patients with uncomplicated type 1 diabetes mellitus. Am J Physiol Renal Physiol. 2015; 308(2): 77-83.
8. Chen W, Liu X, Ye S. Effects of metformin on blood and urine pro-inflammatory mediators in patients with type 2 diabetes. J Inflamm (Lond). 2016; 13:34.
9. Roughley MJ, Belcher J, Mallen CD, Roddy E. Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies. Arthritis Res Ther. 2015; 17(1):90.
10. Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014; 15:122.
11. Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi H. Low-dose aspirin use and recurrent gout attacks. Ann Rheum Dis. 2014; 73(2):385-90.
12. Jasvinder A Singh. Role of serum urate in neurocognitive function and dementia: new evidence contradicts old thinking. Ann Rheum Dis. 2018; 77:317-318.
13. http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid= 762a33a0-a24f-4ab8-befb-ec80073eb972&t=5a047573-cbf8-4d63-a01d-b9b86afe9824
14. https://www.drugs.com/drug-interactions/allopurinol-index.html?filter=3&generic_only=
15. Frampton JE. Febuxostat: a review of its use in the treatment of hyperuricaemia in patients with gout. Drugs. 2015; 75(4):427-38.
16. Chou HY, Chen CB, Cheng CY, Chen YA, Ng CY, Kuo KL. Febuxostat-associated drug reaction with eosinophilia and systemic symptoms (DRESS). J Clin Pharm Ther. 2015; 40(6):689-692.
17. https://www.drugs.com/drug-interactions/febuxostat-index.html?filter=3&generic_only=
18. Roddy E, Packham J, Obrenovic K, Rivett A, Ledingham JM. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology (Oxford). 2018 Feb 13. doi: 10.1093/rheumatology/kex521
19. Dalbeth N, Phipps-Green A,Frampton C, Neogi T, Taylor WJ, Merriman TR. Relationship between serum urate concentrationand clinically evident incident gout: an individualparticipant data analysis. Ann Rheum Dis. 2018;0:1-5. doi:10.1136/annrheumdis-2017-212288
20. Eleftheriadis T, Golphinopoulos S, Pissas G, Stefanidis I. Asympto-matic hyperuricemia and chronic kidney disease: Narrative review of a treatmentcontroversial. J Adv Res. 2017; 8(5):555-560.
21. Sircar D, Chatterjee S, Waikhom R, Golay V, Raychaudhury A, Chatterjee S et al. Efficacy of febuxostat for slowing the GFR decline in patients with CKD and asymptomatic hyperuricemia: a 6-month, double-blind, randomized, placebo-controlled trial. Am J Kidney Dis. 2015; 66: 945-950.
22. Maria Erika G. Ramirez, Joanne M Bargman. Treatment of asymptomatic hyperuricemia in chronic kidney disease: A new target in an old enemy – A review. J Adv Res. 2017 Sep; 8(5): 551-554.
23. Hosoya T, Kimura K, Itoh S, Inaba M, Uchida S, Tomino Y et al.The effect of febuxostat to prevent a further reduction in renal function of patients with hyperuricemia who have never had gout and are complicated by chronic kidney disease stage 3: study protocol for a multicenter randomized controlled study. Trials. 2014; 15: 26.
________________________________________________
2. Amir Qaseem MD, PhD MHA, Russell P, Harris MD MPH, Mary Ann Forciea MD; for the 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. Ann Intern Med. 2017; 166(1):58-68.
3. Richette P et al. 2016 updated EULAR evidence-based recommendations for the management of gout. 2016; 0:1-14.
4. Nielsen SM et al. Weight loss for overweight and obese individuals with gout: a systematic review of longitudinal studies. Ann Rheum Dis. 2017; 76:1870-1882.
5. Larsson SC, Carlström M. Coffee consumption and gout: a Mendelian randomisation study. Ann Rheum Dis. 2018 Feb 28. pii: annrheumdis-2018-213055. doi: 10.1136/annrheumdis-2018-213055
6. Bardin T, Richette P. Impact of comorbidities on gout and hyperuricaemia: an update on prevalence and treatment options. BMC Med. 2017 Jul 3;15(1):123.
7. Lytvyn Y, Skrtic M, Yang GK, Yip PM, Perkins BA, Cherney DZ. Glycosuria-mediated urinary uric acid excretion in patients with uncomplicated type 1 diabetes mellitus. Am J Physiol Renal Physiol. 2015; 308(2): 77-83.
8. Chen W, Liu X, Ye S. Effects of metformin on blood and urine pro-inflammatory mediators in patients with type 2 diabetes. J Inflamm (Lond). 2016; 13:34.
9. Roughley MJ, Belcher J, Mallen CD, Roddy E. Gout and risk of chronic kidney disease and nephrolithiasis: meta-analysis of observational studies. Arthritis Res Ther. 2015; 17(1):90.
10. Li L, Yang C, Zhao Y, Zeng X, Liu F, Fu P. Is hyperuricemia an independent risk factor for new-onset chronic kidney disease? A systematic review and meta-analysis based on observational cohort studies. BMC Nephrol. 2014; 15:122.
11. Zhang Y, Neogi T, Chen C, Chaisson C, Hunter DJ, Choi H. Low-dose aspirin use and recurrent gout attacks. Ann Rheum Dis. 2014; 73(2):385-90.
12. Jasvinder A Singh. Role of serum urate in neurocognitive function and dementia: new evidence contradicts old thinking. Ann Rheum Dis. 2018; 77:317-318.
13. http://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid= 762a33a0-a24f-4ab8-befb-ec80073eb972&t=5a047573-cbf8-4d63-a01d-b9b86afe9824
14. https://www.drugs.com/drug-interactions/allopurinol-index.html?filter=3&generic_only=
15. Frampton JE. Febuxostat: a review of its use in the treatment of hyperuricaemia in patients with gout. Drugs. 2015; 75(4):427-38.
16. Chou HY, Chen CB, Cheng CY, Chen YA, Ng CY, Kuo KL. Febuxostat-associated drug reaction with eosinophilia and systemic symptoms (DRESS). J Clin Pharm Ther. 2015; 40(6):689-692.
17. https://www.drugs.com/drug-interactions/febuxostat-index.html?filter=3&generic_only=
18. Roddy E, Packham J, Obrenovic K, Rivett A, Ledingham JM. Management of gout by UK rheumatologists: a British Society for Rheumatology national audit. Rheumatology (Oxford). 2018 Feb 13. doi: 10.1093/rheumatology/kex521
19. Dalbeth N, Phipps-Green A,Frampton C, Neogi T, Taylor WJ, Merriman TR. Relationship between serum urate concentrationand clinically evident incident gout: an individualparticipant data analysis. Ann Rheum Dis. 2018;0:1-5. doi:10.1136/annrheumdis-2017-212288
20. Eleftheriadis T, Golphinopoulos S, Pissas G, Stefanidis I. Asympto-matic hyperuricemia and chronic kidney disease: Narrative review of a treatmentcontroversial. J Adv Res. 2017; 8(5):555-560.
21. Sircar D, Chatterjee S, Waikhom R, Golay V, Raychaudhury A, Chatterjee S et al. Efficacy of febuxostat for slowing the GFR decline in patients with CKD and asymptomatic hyperuricemia: a 6-month, double-blind, randomized, placebo-controlled trial. Am J Kidney Dis. 2015; 66: 945-950.
22. Maria Erika G. Ramirez, Joanne M Bargman. Treatment of asymptomatic hyperuricemia in chronic kidney disease: A new target in an old enemy – A review. J Adv Res. 2017 Sep; 8(5): 551-554.
23. Hosoya T, Kimura K, Itoh S, Inaba M, Uchida S, Tomino Y et al.The effect of febuxostat to prevent a further reduction in renal function of patients with hyperuricemia who have never had gout and are complicated by chronic kidney disease stage 3: study protocol for a multicenter randomized controlled study. Trials. 2014; 15: 26.
Авторы
С.П. ЯКУПОВА
ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава РФ, Казань, Россия
Associate Professor at Hospital Therapy Department Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University" of the Ministry of Healthcare of the Russian Federation, Kazan, Russia
ГБОУ ВПО «Казанский государственный медицинский университет» Минздрава РФ, Казань, Россия
________________________________________________
Associate Professor at Hospital Therapy Department Federal State Budgetary Educational Institution of Higher Education "Kazan Medical University" of the Ministry of Healthcare of the Russian Federation, Kazan, Russia
Цель портала OmniDoctor – предоставление профессиональной информации врачам, провизорам и фармацевтам.