Jonathan Carcione1, Shari Bodofsky2, Brian LaMoreaux3, Naomi Schlesinger4. 1. Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. jc1908@rwjms.rutgers.edu. 2. Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 3. Horizon Therapeutics, Lake Forest, USA. 4. Division of Rheumatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School Gout Center, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Abstract
PURPOSE OF REVIEW: Medical treatment with urate-lowering therapy (ULT) is efficacious. A recent publication suggested that surgery in gout is more prevalent than previously reported. This revelation led us to review what is known about surgical treatment of gout. RECENT FINDINGS: The Google Scholar database (January 1, 2014-January 1, 2020) found 104 publications with a total of 169 gout patients, with an average disease duration of 6.7 years. Most (68%) were not on ULT. The mean pre-operative serum urate levels were 9.19 mg/dL. One hundred thirteen patients underwent tophi excision, while in 33 patients, tophi were found during surgery. The majority of the surgeries were performed in Asia and Europe. Most patients were not taking ULT at the time of surgery, leading to hyperuricemia. This can result in tophi reformation post-surgery. The role of surgery should be a last-line treatment and until recently has only been demonstrated through case reports.
PURPOSE OF REVIEW: Medical treatment with urate-lowering therapy (ULT) is efficacious. A recent publication suggested that surgery in gout is more prevalent than previously reported. This revelation led us to review what is known about surgical treatment of gout. RECENT FINDINGS: The Google Scholar database (January 1, 2014-January 1, 2020) found 104 publications with a total of 169 goutpatients, with an average disease duration of 6.7 years. Most (68%) were not on ULT. The mean pre-operative serum urate levels were 9.19 mg/dL. One hundred thirteen patients underwent tophi excision, while in 33 patients, tophi were found during surgery. The majority of the surgeries were performed in Asia and Europe. Most patients were not taking ULT at the time of surgery, leading to hyperuricemia. This can result in tophi reformation post-surgery. The role of surgery should be a last-line treatment and until recently has only been demonstrated through case reports.
Authors: Eva Maria Braun; Eva Felizitas Karpf; Sophie Bachna-Rotter; Andreas Lackner; Thorsten Ropposch; Christian Walch; Peter Valentin Tomazic Journal: Otol Neurotol Date: 2016-09 Impact factor: 2.311
Authors: William B White; Kenneth G Saag; Michael A Becker; Jeffrey S Borer; Philip B Gorelick; Andrew Whelton; Barbara Hunt; Majin Castillo; Lhanoo Gunawardhana Journal: N Engl J Med Date: 2018-03-12 Impact factor: 91.245
Authors: Michael A Becker; H Ralph Schumacher; Robert L Wortmann; Patricia A MacDonald; Denise Eustace; William A Palo; Janet Streit; Nancy Joseph-Ridge Journal: N Engl J Med Date: 2005-12-08 Impact factor: 91.245