aggNETs CAN MASK GOUT DISEASE PROGRESSION BY RESOLVING GOUT FLARES AND PAIN‍1,2

Professor Georg Schett, MD’s 2015 paper in RMD Open, “Why does the gout attack stop? A roadmap for the immune pathogenesis of gout,” highlighted a new level of understanding of the progression of gout and the role of aggregated neutrophil extracellular traps (aggNETs) in tophi development.

In his research, Professor Georg Schett, MD discovered that while gout flare resolution may seem to indicate that the disease is no longer progressing, pain resolution is actually characterized by the formation of aggNETs and potentially-damaging tophi.1-4

Professor George Schett, MD
Professor Georg Schett, MD
Erlangen, Germany

“AFTER THE STOP OF THE GOUT ATTACK, GOUT HAS NOT STOPPED, BECAUSE THE URIC ACID CRYSTALS ARE STILL THERE!”

– Professor Georg Schett, MD

A LOWER sUA LEVEL LEADS TO FASTER TOPHI RESOLUTION5,6

Tophi are resolved 97% faster at an sUA level ≤4.0 mg/dL vs an sUA level 5.1-6.0 mg/dL.5,6*

velocity-chart-01b_1

“FOR ME, TOPHUS CLEARANCE IS THE ULTIMATE TREATMENT GOAL FOR A GOUT PATIENT. THE LOWER THE URIC ACID LEVEL IS, THE BETTER IT IS. URIC ACID LEVELS BELOW 3.0 mg/dL ARE VERY GOOD, TO ALLOW RELATIVELY FAST RESOLUTION OF TOPHI.”

– Professor Georg Schett, MD

Adapted with permission from Perez-Ruiz F. Rheumatology (Oxford). 2009;48(suppl 2):ii9-ii14.5
*Based on findings from a prospective study of 63 patients taking oral urate-lowering drugs.

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Additional resources

AMERICAN COLLEGE OF RHEUMATOLOGY (ACR) GUIDELINES FOR MANAGEMENT OF GOUT

AMERICAN COLLEGE OF RHEUMATOLOGY (ACR) GUIDELINES FOR MANAGEMENT OF GOUT
Is your sUA goal low enough to effectively reduce the signs and symptoms of gout and resolve tophi? Review the 2012 ACR guidelines to see if your gout treatment goals line up with industry recommendations.

EUROPEAN LEAGUE AGAINST RHEUMATISM (EULAR) RECOMMENDATIONS FOR MANAGEMENT OF GOUT

EUROPEAN LEAGUE AGAINST RHEUMATISM (EULAR) RECOMMENDATIONS FOR MANAGEMENT OF GOUT
Does your gout treatment intensification strategy match the latest industry guidelines? Review the 2016 EULAR recommendations to see when and why to intensify your approach to treating gout.

WHY DOES THE GOUT ATTACK STOP? A ROADMAP FOR THE IMMUNE PATHOGENESIS OF GOUT

WHY DOES THE GOUT ATTACK STOP? A ROADMAP FOR THE IMMUNE PATHOGENESIS OF GOUT
Read the paper that turned our understanding of gout disease progression on its head. Professor Georg Schett, MD’s 2015 article in RMD Open dissects the mechanisms behind an acute gout attack, from initial urate crystal deposition through the formation of aggNETs.

Bone erosion Bone erosion

THE INTERACTION BETWEEN aggNETs AND BONE

Professor Nicola Dalbeth, MD examines the relationship between tophi and bone erosion in gout.

Review the research
Uric acid Uric acid

WHAT YOU CAN DO

Learn about a treatment option for chronic gout.

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References

  1. Schett G, et al. RMD Open. 2015 Aug 15;1(suppl 1):e000046.
  2. Rada B. J Immunol Res. 2017;2017:2896380.
  3. McQueen FM, et al. Rheumatology (Oxford). 2014;53(1):95-103.
  4. Popovich I, et al. Skeletal Radiol. 2014;43(7):917-924.
  5. Perez-Ruiz F. Rheumatology (Oxford). 2009;48(suppl 2):ii9–ii14.
  6. Perez-Ruiz F, et al. Arthritis Rheum. 2002;47(4):356-360.