A Primary Concern for Today’s Clinician: The Continuing Battle with Gout and Hyperuricemia

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Program Overview:

Gout is an ancient condition, first identified by Egyptians in 2640 BC and later recognized by Hippocrates in the fifth century BC¹; however, it remains a modern-day dilemma for many patients and clinicians. Gout affects more than 1% (5.1 million) of US adults and is the most common form of inflammatory arthritis among men.² Data also indicates that the prevalence and incidence of gout are both on the rise.³ This can be attributed in part to an aging population, increasing obesity, and general changes in lifestyle (eg, diet, alcohol consumption).⁴

There has been substantial progress in improving clinical understanding of gout over the last few decades, and awareness of risk factors contributing to gout has continued to expand. It is crucial to the successful management of gout that the clinician recognizes whether symptoms are acute or chronic, and after making that differentiation, to utilize the appropriate management strategy.

This program will outline the newest evidence-based standards for making a definitive diagnosis of gout; highlight practice recommendations to improve competence and confidence when treating gout; and discuss emerging therapies that might further contribute to improving clinical outcomes.

1. Nuki G, Simkin PA. A concise history of gout and hyperuricemia and their treatment. Arthritis Res Ther. 2006;8[suppl 1]:S1
2. Saag KG, Choi H. Epidemiology, risk factors, and lifestyle modifications for gout. Arthritis Res Ther. 2006;8[suppl 1]:S2
3. Weaver AL. Epidemiology of gout. Cleve Clin J Med. 2008;75[suppl 5]:S9- S12
4. Underwood M. Diagnosis and management of gout. BMJ. 2006;332:1315-1319

Learning Objectives

After completing this activity, the participant will be able to:

• Differentiate the clinical presentation of acute versus chronic gout by using up-to-date American College of Rheumatology and European League Against Rheumatism recommendations for making a diagnosis of gout, including knowing when it is appropriate to perform a presumptive diagnosis
• Devise a treatment plan specific to the needs of both acute and chronic gout disease states that include individualized therapy, patient adherence, and consideration of comorbidities

Accreditation/Designation Statement

Primary Care Network, Inc. is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Primary Care Network designates this educational activity for a maximum of 1.25 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Target Audience:
This activity is targeted to all physicians and other healthcare professionals who treat patients with gout.

Release Date: February 23, 2009
Expiration Date: February 23, 2010

Medium: Podcast

Acknowledgement of Commercial Support:

This activity was developed from the live Best Practices in Primary Care™ program held in Dearborn, Michigan on November 22, 2008 which was funded by Takeda Pharmaceuticals North America, Inc.

Method of Participation:

To receive CME credit for this activity, you need to listen to the program. Upon finishing the podcast, complete the post-test and evaluation, and fill out all required personal information. To receive your CME certificate you will need to pass the post-test with 70% accuracy or better.

Post-test and Evaluation:

After completing this activity, click on the Post-test button at the end of the program. If you receive less than 70% on the post-test, you will be returned to the beginning of the activity to review the presentation again. Upon successful completion of the post-test, you will be asked to fill out a program evaluation form and prompted to print your CME certificate.

Statement of Disclosure and Independence:

It is the policy of Primary Care Network, Inc. to ensure all its sponsored educational activities are planned, developed, and conducted in accordance with the ACCME’s Essential Areas and Policies. In accordance with ACCME requirements, Primary Care Network has Conflict of Interest and Disclosure Policies that are designed to ensure that Primary Care Network sponsored educational activities are fair balanced, independent, evidence-based and based on scientific rigor.

Primary Care Network’s Resolution of Personal Conflicts of Interest (COI) Policy aims to ensure that all conflicts are resolved prior to the activity, content is developed and presented free of commercial bias, and is in the interest of promoting improvements or quality in healthcare. All individuals who are in a position to influence and/or control content of a Primary Care Network sponsored activity are required to disclose to the participants any real or apparent conflict of interest related to the activity. The educational content is also reviewed for independence and content validation by an independent external clinical reviewer and internal clinical reviewer. Independence is also monitored through the activity and overall program evaluation process.

The opinions, ideas, recommendations, and perspectives expressed in the accompanying presentations at this Primary Care Education program are those of the program authors and presenting faculty only and do not necessarily reflect the opinions, ideas, recommendations or perspectives of their affiliated institutions, Primary Care Network, Primary Care Education, Advisory Boards and Consultants, or the activity’s commercial supporters.

Faculty and Disclosures

Arthur L. Weaver, MD, MS, FACP, MACR
Clinical Professor of Medicine Emeritus
Department of Medicine
Section of Rheumatology
University of Nebraska Medical Center
Omaha, NE

Dr. Weaver is a member of the speaker’s bureau for, serves on the advisory board for, and is a consultant to Alpharma Inc., Amgen Inc., Biogen Idec, Genentech, Inc., Merck & Co., Inc., Novartis Pharmaceuticals, Pfizer, Inc., Primus Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc., and Wyeth Pharmaceuticals. He also is a member of the speaker’s bureau and serves on the advisory board for Abbott Laboratories and Bristol-Myers Squibb Company.

Joseph D. Croft Jr, MD
Clinical Professor of Medicine (Rheumatology)
Georgetown University Medical School
Washington, DC

Dr. Croft serves on the advisory board for Savient Pharmaceuticals, Inc. and Takeda Pharmaceuticals North America, Inc.

Planning Committee and Disclosures

Arthur L. Weaver, MD, MS, FACP, MACR
Clinical Professor of Medicine Emeritus
Department of Medicine
Section of Rheumatology
University of Nebraska Medical Center
Omaha, NE

Dr. Weaver is a member of the speaker’s bureau for, serves on the advisory board for, and is a consultant to Alpharma Inc., Amgen Inc., Biogen Idec, Genentech, Inc., Merck & Co., Inc., Novartis Pharmaceuticals, Pfizer, Inc., Primus Pharmaceuticals, Inc., Takeda Pharmaceuticals North America, Inc., and Wyeth Pharmaceuticals. He also is a member of the speaker’s bureau and serves on the advisory board for Abbott Laboratories and Bristol-Myers Squibb Company.

Elke Graser
Medical Writer
The Customer Link, Inc.
Cary, NC

Elke Graser has nothing to disclose.

Karin Yao
Project Manager
The Customer Link, Inc.
Cary, NC

Karin Yao has nothing to disclose.

Review Committee Disclosure

In accordance with our policy, all content is reviewed by external independent peer reviewers for balance, objectivity and commercial bias. The peer reviewers, staff, and other individuals who control content have no relevant financial relationships to disclose.

Unlabeled Use Declaration:

During their presentation(s), faculty may discuss an unlabeled use or an investigational use not approved for a commercial product. Each faculty member is required to disclose this information to the audience when referring to an unlabeled or investigational use.

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