Multinational evidence-based recommendations for the diagnosis and management of gout: integrating systematic literature review and expert opinion of a broad panel of rheumatologists in the 3e initiative

Francisca Sivera, Mariano Andrés, Loreto Carmona, Alison Kydd, John Moi, Rakhi Seth, Melonie Sriranganathan, Caroline van Durme, Irene van Echteld, Ophir Vinik, Mihir Wechalekar, Daniel Aletaha, Claire Bombardier, Rachelle Buchbinder, Christopher Edwards, Robert Landewé, Johannes Bijlsma, Jaime Branco, Rubén Burgos-Vargas, Anca CatrinaDirk Elewaut, Antonio Ferrari, Patrick Kiely, Burkhard Leeb, Carlomaurizio Montecucco, Ulf Müller-Ladner, Mikkel Østergaard, Jane Zochling, Louise Falzon, Désirée van der Heijde

    Research output: Contribution to journalArticlepeer-review

    175 Citations (Scopus)

    Abstract

    We aimed to develop evidence-based multinational recommendations for the diagnosis and management of gout. Using a formal voting process, a panel of 78 international rheumatologists developed 10 key clinical questions pertinent to the diagnosis and management of gout. Each question was investigated with a systematic literature review. Medline, Embase, Cochrane CENTRAL and abstracts from 2010-2011 European League Against Rheumatism and American College of Rheumatology meetings were searched in each review. Relevant studies were independently reviewed by two individuals for data extraction and synthesis and risk of bias assessment. Using this evidence, rheumatologists from 14 countries (Europe, South America and Australasia) developed national recommendations. After rounds of discussion and voting, multinational recommendations were formulated. Each recommendation was graded according to the level of evidence. Agreement and potential impact on clinical practice were assessed. Combining evidence and clinical expertise, 10 recommendations were produced. One recommendation referred to the diagnosis of gout, two referred to cardiovascular and renal comorbidities, six focused on different aspects of the management of gout (including drug treatment and monitoring), and the last recommendation referred to the management of asymptomatic hyperuricaemia. The level of agreement with the recommendations ranged from 8.1 to 9.2 (mean 8.7) on a 1-10 scale, with 10 representing full agreement. Ten recommendations on the diagnosis and management of gout were established. They are evidence-based and supported by a large panel of rheumatologists from 14 countries, enhancing their utility in clinical practice.

    Original languageEnglish
    Pages (from-to)328-335
    Number of pages8
    JournalAnnals of the Rheumatic Diseases
    Volume73
    Issue number2
    DOIs
    Publication statusPublished - Feb 2014

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