Dr. Singh serves on the US Food and Drug Administration Arthritis Advisory Committee. Knowledge of patient preferences and values is valuable and was influential for the development of the 2020 ACR gout treatment guideline. Dr. Singh previously served as a member of the ACR Annual Meeting Planning Committee and Quality of Care Committee, as the chair of the ACR Meet the Professor/Workshop/Study Group Subcommittee, and as the co‐chair of the ACR Criteria and Response Criteria Subcommittee. When do you live without family and have frequent attacks, [y]ou’ve got to do what you’ve got to do.”, Clinical scenario 9: Lifestyle modifications: Weight Loss, “Depends a lot on whether you’re being under control with other means.”, “I don’t think doctors talk to you about weight problem with gout. Reduction in alcohol use and weight loss were considerations for the patient but only if discussed by their provider as effective strategies for gout management (no vote for this statement). Founded in 1934, we are a not-for … They also provided their preference for one of the two treatment options for each clinical scenario. MONDAY, Nov. 16, 2020 -- For adults with atrial fibrillation, warfarin is associated with an increased risk for knee and hip replacements for osteoarthritis, according to a study presented at ACR Convergence, the annual meeting of the American College of Rheumatology, held virtually from Nov. 5 to 9. Fellow in Training Member, Annual Meeting Planning Committee American College of Rheumatology 2017 - 2018 Member Connective Tissue Disease Subspecialty Group, Division of Rheumatology, … I don’t like the needle. Invitation emails asking patients to participate in a 6‐hour focus group were sent to patients by ACR staff. Dr. Singh owns stock options in Vaxart Pharmaceuticals and Charlotte's Web Holdings, Inc. Dr. Singh previously owned stock options in Amarin, Viking, and Moderna Pharmaceuticals. The conference featured presentations focusing on the latest advances in the diagnosis and treatment of arthritis as well as other rheumatic and musculoskeletal diseases. I can’t take that stuff in particular. HCQ remains a safe, effective long-term DMARD for our rheumatic patients. Most patients were in favor of taking anti‐inflammatory prophylaxis when starting ULT. The patient panel also was not concerned about receiving information about management of the gout flare and long‐term management of their gout at the same time. The American College of Rheumatology (ACR) (Wolfe, et al. The researchers found that warfarin users had a 57 percent increased risk for having a knee replacement or hip replacement compared with DOAC users. I went in a wheelchair to my rheumatologist. Specific contributions from such panels include not only a better understanding of the patient perspectives toward treatment and management decisions in the real‐world scenarios but also an in‐depth knowledge of their values and preferences (9) that likely play a critical role in treatment decision‐making and adherence. Two authors disclosed financial ties to the pharmaceutical industry. The members understood the hypothetical concern about overloading patients with ULT information and medications during a gout flare, but the panel felt that most patients would be able to adequately follow ULT education during a gout flare (Table 1). Many people continued to consume drinks with high‐fructose corn syrup, such as sodas. If you didn’t have insurance, maybe it costs a lot more.”. Of these eight participants, seven received their gout care from a rheumatologist and one from a primary care physician. Most patients were comfortable with taking colchicine or taking nonsteroidal anti‐inflammatory drugs (NSAIDs) (Table 1). The 2020 guideline supplemented their systematic literature reviews with input from patients on their values and preferences regarding the benefits and risks of treatment options. They put me in a sling. One patient with concomitant kidney disease would not take it because he worried about potential kidney side effects. However, if they had mild gout that was controlled by medication, then a diet change was not a priority. The patient panel reviewed several clinical treatment scenarios for gout management, along with the evidence report, one at a time. The patient panel discussion summary related to several specific questions was also useful because it was reviewed with the 2020 ACR gout guideline voting panel members prior to their discussions and final vote on these same clinical scenarios (see Supplementary Appendix 1). Abbreviations: QOL, quality of life; SAE, serious adverse event; sUA, serum urate. The ACR represents more than 7,700 rheumatologists and rheumatology health professionals around the world. MONDAY, Nov. 16, 2020 -- The American College of Rheumatology (ACR) previewed its 2020 Guideline for the Management of Rheumatoid Arthritis at ACR Convergence, the College's annual meeting, held virtually from Nov. 5 to 9. The primary outcome measure was QTc length and the primary predictor was HCQ use, adjusted for several covariates, including RA and SLE disease factors, cardiovascular risk factors, and other QTc-prolonging medications. Mine is mild, but by taking my medication every day; that’s what keeps it mild.”, “I have mild also, but I believe in keeping my pill on.”, “I do it [take ULT] to reduce the risk of gout flare and the tophi.”, “I think allopurinol is one of the best medicines you can take.”, “It’s a pill you take once a day. The gout was worse than my surgery.”, “When you have gout in heels, every step makes you hurt.”, “I have a sports car. A lay language version of the document was created and provided to patients for their review during the patient meeting discussions (Supplementary Appendix 1). Jasvinder A. Singh, Tuhina Neogi, John D. FitzGerald, Patient Perspectives on Gout and Gout Treatments: A Patient Panel Discussion That Informed the 2020 American College of Rheumatology Treatment Guideline, ACR Open Rheumatology… We are a professional membership organization committed to improving the care of patients with rheumatic disease and advancing the rheumatology subspecialty. [Original Research], Nurse‐led care is preferred over GP‐led care of gout and improves gout outcomes: results of Nottingham Gout Treatment Trial follow‐up study, Facilitators and barriers to adherence to urate‐lowering therapy in African‐Americans with gout: a qualitative study, Patient perceptions of gout management goals: a cross‐sectional internet survey, A cross‐sectional internet‐based patient survey of the management strategies for gout, The direct economic burden of gout in an elderly canadian population, A systematic review of the economic and humanistic burden of gout, Patients' knowledge and beliefs concerning gout and its treatment: a population based study, Patients and providers view gout differently: a qualitative study, The dynamics of chronic gout treatment: medication gaps and return to therapy, Adherence with urate‐lowering therapies for the treatment of gout, The impact of gout on patient's lives: a study of African‐American and Caucasian men and women with gout, https://www.nationalacademies.org/our‐work/standards‐for‐developing‐trustworthy‐clinical‐practice‐guidelines, http://www.g‐i‐n.net/working‐groups/gin‐public/toolkit, https://www.agreetrust.org/wp‐content/uploads/2013/12/AGREE‐II‐GRS‐Instument.pdf, Clinical scenario 1: Starting ULT for gout, “I was just treating symptoms and I thought I was fine.”, “Mine kind of started that way, mild. The patient panel included eight men with gout. The discussion was recorded, transcribed verbatim, and reviewed for the accuracy of notes taken during the meeting by ACR staff. Despite being called the “curable disease” (1), practice gaps in gout management continue to persist (2). It really worked for me, when nothing else worked” (Table 1). But the other pill, I may take.”, “There are trade‐offs with everything in life.”, “Age plays a factor. However, some had curtailed their occasional beer drinking because of the risk of gout flares. Our study results should be interpreted while considering study limitations. The panel remained unanimous in their support of ULT treatment even for patients with mild gout because the panel members valued preventing long‐term negative outcomes, such as recurrent flares or tophi, over any inconvenience of daily ULT. For patients with moderate severity of flares and tophi that negatively impacted QOL, the panel still recommended beginning pegloticase. 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