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
Identifieur interne : 000187 ( Ncbi/Checkpoint ); précédent : 000186; suivant : 000188Multinational 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
Auteurs : Francisca Sivera [Espagne] ; Mariano Andrés [Espagne] ; Loreto Carmona [Espagne] ; Alison S R. Kydd [Canada] ; John Moi [Australie] ; Rakhi Seth [Royaume-Uni] ; Melonie Sriranganathan [Royaume-Uni] ; Caroline Van Durme [Belgique, Pays-Bas] ; Irene Van Echteld [Pays-Bas] ; Ophir Vinik [Canada] ; Mihir D. Wechalekar [Australie] ; Daniel Aletaha [Autriche] ; Claire Bombardier [Canada] ; Rachelle Buchbinder [Australie] ; Christopher J. Edwards [Royaume-Uni] ; Robert B. Landewé [Pays-Bas] ; Johannes W. Bijlsma [Pays-Bas] ; Jaime C. Branco [Portugal] ; Rubén Burgos-Vargas [Mexique] ; Anca I. Catrina [Suède] ; Dirk Elewaut [Belgique] ; Antonio J L. Ferrari [Brésil] ; Patrick Kiely [Royaume-Uni] ; Burkhard F. Leeb [Autriche] ; Carlomaurizio Montecucco [Italie] ; Ulf Müller-Ladner [Allemagne] ; Mikkel Stergaard [Danemark] ; Jane Zochling [Australie] ; Louise Falzon [États-Unis] ; Désirée M. Van Der Heijde [Pays-Bas]Source :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2013.
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.
Url:
DOI: 10.1136/annrheumdis-2013-203325
PubMed: 23868909
PubMed Central: 3913257
Affiliations:
- Allemagne, Australie, Autriche, Belgique, Brésil, Canada, Danemark, Espagne, Italie, Mexique, Pays-Bas, Portugal, Royaume-Uni, Suède, États-Unis
Links toward previous steps (curation, corpus...)
- to stream Pmc, to step Corpus: 000313
- to stream Pmc, to step Curation: 000313
- to stream Pmc, to step Checkpoint: 000259
- to stream Ncbi, to step Merge: 000187
- to stream Ncbi, to step Curation: 000187
Links to Exploration step
PMC:3913257Le document en format XML
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<author><name sortKey="Andres, Mariano" sort="Andres, Mariano" uniqKey="Andres M" first="Mariano" last="Andrés">Mariano Andrés</name>
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<author><name sortKey="Kydd, Alison S R" sort="Kydd, Alison S R" uniqKey="Kydd A" first="Alison S R" last="Kydd">Alison S R. Kydd</name>
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<author><name sortKey="Moi, John" sort="Moi, John" uniqKey="Moi J" first="John" last="Moi">John Moi</name>
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<author><name sortKey="Seth, Rakhi" sort="Seth, Rakhi" uniqKey="Seth R" first="Rakhi" last="Seth">Rakhi Seth</name>
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<author><name sortKey="Sriranganathan, Melonie" sort="Sriranganathan, Melonie" uniqKey="Sriranganathan M" first="Melonie" last="Sriranganathan">Melonie Sriranganathan</name>
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<author><name sortKey="Van Durme, Caroline" sort="Van Durme, Caroline" uniqKey="Van Durme C" first="Caroline" last="Van Durme">Caroline Van Durme</name>
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<affiliation wicri:level="1"><nlm:aff id="af8"><addr-line>Department of Internal Medicine/Rheumatology</addr-line>
,<institution>Maastricht University Medical Centre</institution>
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<author><name sortKey="Van Echteld, Irene" sort="Van Echteld, Irene" uniqKey="Van Echteld I" first="Irene" last="Van Echteld">Irene Van Echteld</name>
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<author><name sortKey="Vinik, Ophir" sort="Vinik, Ophir" uniqKey="Vinik O" first="Ophir" last="Vinik">Ophir Vinik</name>
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<author><name sortKey="Wechalekar, Mihir D" sort="Wechalekar, Mihir D" uniqKey="Wechalekar M" first="Mihir D" last="Wechalekar">Mihir D. Wechalekar</name>
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<author><name sortKey="Aletaha, Daniel" sort="Aletaha, Daniel" uniqKey="Aletaha D" first="Daniel" last="Aletaha">Daniel Aletaha</name>
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<author><name sortKey="Bombardier, Claire" sort="Bombardier, Claire" uniqKey="Bombardier C" first="Claire" last="Bombardier">Claire Bombardier</name>
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<author><name sortKey="Buchbinder, Rachelle" sort="Buchbinder, Rachelle" uniqKey="Buchbinder R" first="Rachelle" last="Buchbinder">Rachelle Buchbinder</name>
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,<addr-line>Malvern, Victoria</addr-line>
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<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<affiliation wicri:level="1"><nlm:aff id="af16"><addr-line>Department of Epidemiology and Preventive Medicine</addr-line>
,<institution>Monash University</institution>
,<addr-line>Malvern, Victoria</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Edwards, Christopher J" sort="Edwards, Christopher J" uniqKey="Edwards C" first="Christopher J" last="Edwards">Christopher J. Edwards</name>
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,<addr-line>Southampton</addr-line>
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<author><name sortKey="Landewe, Robert B" sort="Landewe, Robert B" uniqKey="Landewe R" first="Robert B" last="Landewé">Robert B. Landewé</name>
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<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Bijlsma, Johannes W" sort="Bijlsma, Johannes W" uniqKey="Bijlsma J" first="Johannes W" last="Bijlsma">Johannes W. Bijlsma</name>
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,<addr-line>Utrecht</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
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<author><name sortKey="Branco, Jaime C" sort="Branco, Jaime C" uniqKey="Branco J" first="Jaime C" last="Branco">Jaime C. Branco</name>
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,<institution>Universidade Nova de Lisboa</institution>
,<addr-line>Lisboa</addr-line>
,<country>Portugal</country>
</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af20"><addr-line>Rheumatology Department, CHLO</addr-line>
,<institution>EPE—Hospital Egas Moniz</institution>
,<addr-line>Lisboa</addr-line>
,<country>Portugal</country>
</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Burgos Vargas, Ruben" sort="Burgos Vargas, Ruben" uniqKey="Burgos Vargas R" first="Rubén" last="Burgos-Vargas">Rubén Burgos-Vargas</name>
<affiliation wicri:level="1"><nlm:aff id="af21"><addr-line>Rheumatology Unit</addr-line>
,<institution>Hospital General de México</institution>
,<addr-line>Mexico City</addr-line>
,<country>Mexico</country>
</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Catrina, Anca I" sort="Catrina, Anca I" uniqKey="Catrina A" first="Anca I" last="Catrina">Anca I. Catrina</name>
<affiliation wicri:level="1"><nlm:aff id="af22"><addr-line>Department of Rheumatology</addr-line>
,<institution>Karolinska University Hospital and Karolinska Institutet</institution>
,<addr-line>Stockholm</addr-line>
,<country>Sweden</country>
</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Elewaut, Dirk" sort="Elewaut, Dirk" uniqKey="Elewaut D" first="Dirk" last="Elewaut">Dirk Elewaut</name>
<affiliation wicri:level="1"><nlm:aff id="af23"><addr-line>Department of Rheumatology</addr-line>
,<institution>Ghent University Hospital</institution>
,<addr-line>Ghent</addr-line>
,<country>Belgium</country>
</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ferrari, Antonio J L" sort="Ferrari, Antonio J L" uniqKey="Ferrari A" first="Antonio J L" last="Ferrari">Antonio J L. Ferrari</name>
<affiliation wicri:level="1"><nlm:aff id="af24"><addr-line>Rheumatology Division</addr-line>
,<institution>Universidade Federal de São Paulo</institution>
,<addr-line>São Paulo-SP</addr-line>
,<country>Brazil</country>
</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kiely, Patrick" sort="Kiely, Patrick" uniqKey="Kiely P" first="Patrick" last="Kiely">Patrick Kiely</name>
<affiliation wicri:level="1"><nlm:aff id="af25"><addr-line>Department of Rheumatology</addr-line>
,<institution>St George's Healthcare NHS Trust</institution>
,<addr-line>London</addr-line>
,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Leeb, Burkhard F" sort="Leeb, Burkhard F" uniqKey="Leeb B" first="Burkhard F" last="Leeb">Burkhard F. Leeb</name>
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,<addr-line>Stockerau</addr-line>
,<country>Austria</country>
</nlm:aff>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name>
<affiliation wicri:level="1"><nlm:aff id="af27"><addr-line>Cattedra di Reumatologia</addr-line>
,<institution>IRCCS Policlinico S. Matteo, Università di Pavia</institution>
,<addr-line>Pavia</addr-line>
,<country>Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Muller Ladner, Ulf" sort="Muller Ladner, Ulf" uniqKey="Muller Ladner U" first="Ulf" last="Müller-Ladner">Ulf Müller-Ladner</name>
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,<institution>Justus-Liebig-University, Kerckhoff Klinik</institution>
,<addr-line>Bad Nauheim</addr-line>
,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey=" Stergaard, Mikkel" sort=" Stergaard, Mikkel" uniqKey=" Stergaard M" first="Mikkel" last=" Stergaard">Mikkel Stergaard</name>
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,<addr-line>Glostrup</addr-line>
,<country>Denmark</country>
</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Zochling, Jane" sort="Zochling, Jane" uniqKey="Zochling J" first="Jane" last="Zochling">Jane Zochling</name>
<affiliation wicri:level="1"><nlm:aff id="af30"><institution>Menzies Research Institute Tasmania</institution>
,<addr-line>Hobart</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Falzon, Louise" sort="Falzon, Louise" uniqKey="Falzon L" first="Louise" last="Falzon">Louise Falzon</name>
<affiliation wicri:level="1"><nlm:aff id="af31"><institution>Columbia University Medical Center</institution>
,<addr-line>New York, New York</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Van Der Heijde, Desiree M" sort="Van Der Heijde, Desiree M" uniqKey="Van Der Heijde D" first="Désirée M" last="Van Der Heijde">Désirée M. Van Der Heijde</name>
<affiliation wicri:level="1"><nlm:aff id="af32"><institution>Leiden University Medical Center</institution>
,<addr-line>Leiden</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">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</title>
<author><name sortKey="Sivera, Francisca" sort="Sivera, Francisca" uniqKey="Sivera F" first="Francisca" last="Sivera">Francisca Sivera</name>
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,<institution>Hospital General Universitario de Elda</institution>
,<addr-line>Elda</addr-line>
,<country>Spain</country>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Andres, Mariano" sort="Andres, Mariano" uniqKey="Andres M" first="Mariano" last="Andrés">Mariano Andrés</name>
<affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department Reumatologia</addr-line>
,<institution>Hospital General Universitario de Alicante</institution>
,<addr-line>Alicante</addr-line>
,<country>Spain</country>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Carmona, Loreto" sort="Carmona, Loreto" uniqKey="Carmona L" first="Loreto" last="Carmona">Loreto Carmona</name>
<affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Facultad de Ciencias de la Salud</addr-line>
,<institution>Universidad Camilo Jose Cela</institution>
,<addr-line>Madrid</addr-line>
,<country>Spain</country>
</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kydd, Alison S R" sort="Kydd, Alison S R" uniqKey="Kydd A" first="Alison S R" last="Kydd">Alison S R. Kydd</name>
<affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Division of Rheumatology</addr-line>
,<institution>University of British Columbia</institution>
,<addr-line>Vancouver, British Columbia</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Moi, John" sort="Moi, John" uniqKey="Moi J" first="John" last="Moi">John Moi</name>
<affiliation wicri:level="1"><nlm:aff id="af5"><institution>Royal Melbourne Hospital</institution>
,<addr-line>Parkville</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Seth, Rakhi" sort="Seth, Rakhi" uniqKey="Seth R" first="Rakhi" last="Seth">Rakhi Seth</name>
<affiliation wicri:level="1"><nlm:aff id="af6"><institution>University Hospital Southampton NHS Foundation Trust & NIHR Wellcome Trust Clinical Research Facility</institution>
,<addr-line>Southampton</addr-line>
,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Sriranganathan, Melonie" sort="Sriranganathan, Melonie" uniqKey="Sriranganathan M" first="Melonie" last="Sriranganathan">Melonie Sriranganathan</name>
<affiliation wicri:level="1"><nlm:aff id="af6"><institution>University Hospital Southampton NHS Foundation Trust & NIHR Wellcome Trust Clinical Research Facility</institution>
,<addr-line>Southampton</addr-line>
,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Van Durme, Caroline" sort="Van Durme, Caroline" uniqKey="Van Durme C" first="Caroline" last="Van Durme">Caroline Van Durme</name>
<affiliation wicri:level="1"><nlm:aff id="af7"><institution>Centre Hospitalier Universitaire de Liège</institution>
,<addr-line>Liège</addr-line>
,<country>Belgium</country>
</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af8"><addr-line>Department of Internal Medicine/Rheumatology</addr-line>
,<institution>Maastricht University Medical Centre</institution>
,<addr-line>Maastricht</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Van Echteld, Irene" sort="Van Echteld, Irene" uniqKey="Van Echteld I" first="Irene" last="Van Echteld">Irene Van Echteld</name>
<affiliation wicri:level="1"><nlm:aff id="af9"><institution>Atrium Medical Centre</institution>
,<addr-line>Heerlen</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Vinik, Ophir" sort="Vinik, Ophir" uniqKey="Vinik O" first="Ophir" last="Vinik">Ophir Vinik</name>
<affiliation wicri:level="1"><nlm:aff id="af10"><addr-line>Division of Rheumatology</addr-line>
,<institution>University of Toronto</institution>
,<addr-line>Toronto, Ontario</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Wechalekar, Mihir D" sort="Wechalekar, Mihir D" uniqKey="Wechalekar M" first="Mihir D" last="Wechalekar">Mihir D. Wechalekar</name>
<affiliation wicri:level="1"><nlm:aff id="af11"><addr-line>Rheumatology Research Unit</addr-line>
,<institution>Repatriation General Hospital and Flinders University</institution>
,<addr-line>Adelaide</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Aletaha, Daniel" sort="Aletaha, Daniel" uniqKey="Aletaha D" first="Daniel" last="Aletaha">Daniel Aletaha</name>
<affiliation wicri:level="1"><nlm:aff id="af12"><addr-line>Division of Rheumatology, Department of Internal Medicine 3</addr-line>
,<institution>Medical University of Vienna</institution>
,<addr-line>Vienna</addr-line>
,<country>Austria</country>
</nlm:aff>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bombardier, Claire" sort="Bombardier, Claire" uniqKey="Bombardier C" first="Claire" last="Bombardier">Claire Bombardier</name>
<affiliation wicri:level="1"><nlm:aff id="af13"><addr-line>Division of rheumatology and Department of Health Policy, Management, and Evaluation</addr-line>
,<institution>University of Toronto</institution>
,<addr-line>Toronto, Ontario</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af14"><addr-line>Division of Clinical Decision Making and Health Care</addr-line>
,<institution>Toronto General Research Institute, University Health Network, Mount Sinai Hospital</institution>
,<addr-line>Toronto, Ontario</addr-line>
,<country>Canada</country>
</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Buchbinder, Rachelle" sort="Buchbinder, Rachelle" uniqKey="Buchbinder R" first="Rachelle" last="Buchbinder">Rachelle Buchbinder</name>
<affiliation wicri:level="1"><nlm:aff id="af15"><addr-line>Monash Department of Clinical Epidemiology</addr-line>
,<institution>Cabrini Hospital</institution>
,<addr-line>Malvern, Victoria</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af16"><addr-line>Department of Epidemiology and Preventive Medicine</addr-line>
,<institution>Monash University</institution>
,<addr-line>Malvern, Victoria</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Edwards, Christopher J" sort="Edwards, Christopher J" uniqKey="Edwards C" first="Christopher J" last="Edwards">Christopher J. Edwards</name>
<affiliation wicri:level="1"><nlm:aff id="af6"><institution>University Hospital Southampton NHS Foundation Trust & NIHR Wellcome Trust Clinical Research Facility</institution>
,<addr-line>Southampton</addr-line>
,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Landewe, Robert B" sort="Landewe, Robert B" uniqKey="Landewe R" first="Robert B" last="Landewé">Robert B. Landewé</name>
<affiliation wicri:level="1"><nlm:aff id="af9"><institution>Atrium Medical Centre</institution>
,<addr-line>Heerlen</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af17"><addr-line>Department of Clinical Immunology and Rheumatology</addr-line>
,<institution>Academic Medical Center/University of Amsterdam</institution>
,<addr-line>Amsterdam</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Bijlsma, Johannes W" sort="Bijlsma, Johannes W" uniqKey="Bijlsma J" first="Johannes W" last="Bijlsma">Johannes W. Bijlsma</name>
<affiliation wicri:level="1"><nlm:aff id="af18"><addr-line>Department of Rheumatology and Clinical Immunology</addr-line>
,<institution>University Medical Center Utrecht</institution>
,<addr-line>Utrecht</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Branco, Jaime C" sort="Branco, Jaime C" uniqKey="Branco J" first="Jaime C" last="Branco">Jaime C. Branco</name>
<affiliation wicri:level="1"><nlm:aff id="af19"><addr-line>CEDOC, Faculdade Ciências Médicas</addr-line>
,<institution>Universidade Nova de Lisboa</institution>
,<addr-line>Lisboa</addr-line>
,<country>Portugal</country>
</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="af20"><addr-line>Rheumatology Department, CHLO</addr-line>
,<institution>EPE—Hospital Egas Moniz</institution>
,<addr-line>Lisboa</addr-line>
,<country>Portugal</country>
</nlm:aff>
<country xml:lang="fr">Portugal</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Burgos Vargas, Ruben" sort="Burgos Vargas, Ruben" uniqKey="Burgos Vargas R" first="Rubén" last="Burgos-Vargas">Rubén Burgos-Vargas</name>
<affiliation wicri:level="1"><nlm:aff id="af21"><addr-line>Rheumatology Unit</addr-line>
,<institution>Hospital General de México</institution>
,<addr-line>Mexico City</addr-line>
,<country>Mexico</country>
</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Catrina, Anca I" sort="Catrina, Anca I" uniqKey="Catrina A" first="Anca I" last="Catrina">Anca I. Catrina</name>
<affiliation wicri:level="1"><nlm:aff id="af22"><addr-line>Department of Rheumatology</addr-line>
,<institution>Karolinska University Hospital and Karolinska Institutet</institution>
,<addr-line>Stockholm</addr-line>
,<country>Sweden</country>
</nlm:aff>
<country xml:lang="fr">Suède</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Elewaut, Dirk" sort="Elewaut, Dirk" uniqKey="Elewaut D" first="Dirk" last="Elewaut">Dirk Elewaut</name>
<affiliation wicri:level="1"><nlm:aff id="af23"><addr-line>Department of Rheumatology</addr-line>
,<institution>Ghent University Hospital</institution>
,<addr-line>Ghent</addr-line>
,<country>Belgium</country>
</nlm:aff>
<country xml:lang="fr">Belgique</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Ferrari, Antonio J L" sort="Ferrari, Antonio J L" uniqKey="Ferrari A" first="Antonio J L" last="Ferrari">Antonio J L. Ferrari</name>
<affiliation wicri:level="1"><nlm:aff id="af24"><addr-line>Rheumatology Division</addr-line>
,<institution>Universidade Federal de São Paulo</institution>
,<addr-line>São Paulo-SP</addr-line>
,<country>Brazil</country>
</nlm:aff>
<country xml:lang="fr">Brésil</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Kiely, Patrick" sort="Kiely, Patrick" uniqKey="Kiely P" first="Patrick" last="Kiely">Patrick Kiely</name>
<affiliation wicri:level="1"><nlm:aff id="af25"><addr-line>Department of Rheumatology</addr-line>
,<institution>St George's Healthcare NHS Trust</institution>
,<addr-line>London</addr-line>
,<country>UK</country>
</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Leeb, Burkhard F" sort="Leeb, Burkhard F" uniqKey="Leeb B" first="Burkhard F" last="Leeb">Burkhard F. Leeb</name>
<affiliation wicri:level="1"><nlm:aff id="af26"><institution>State Hospital Stockerau, Center for Rheumatology, Lower Austria</institution>
,<addr-line>Stockerau</addr-line>
,<country>Austria</country>
</nlm:aff>
<country xml:lang="fr">Autriche</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Montecucco, Carlomaurizio" sort="Montecucco, Carlomaurizio" uniqKey="Montecucco C" first="Carlomaurizio" last="Montecucco">Carlomaurizio Montecucco</name>
<affiliation wicri:level="1"><nlm:aff id="af27"><addr-line>Cattedra di Reumatologia</addr-line>
,<institution>IRCCS Policlinico S. Matteo, Università di Pavia</institution>
,<addr-line>Pavia</addr-line>
,<country>Italy</country>
</nlm:aff>
<country xml:lang="fr">Italie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Muller Ladner, Ulf" sort="Muller Ladner, Ulf" uniqKey="Muller Ladner U" first="Ulf" last="Müller-Ladner">Ulf Müller-Ladner</name>
<affiliation wicri:level="1"><nlm:aff id="af28"><addr-line>Department of Rheumatology and Clinical Immunology</addr-line>
,<institution>Justus-Liebig-University, Kerckhoff Klinik</institution>
,<addr-line>Bad Nauheim</addr-line>
,<country>Germany</country>
</nlm:aff>
<country xml:lang="fr">Allemagne</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey=" Stergaard, Mikkel" sort=" Stergaard, Mikkel" uniqKey=" Stergaard M" first="Mikkel" last=" Stergaard">Mikkel Stergaard</name>
<affiliation wicri:level="1"><nlm:aff id="af29"><institution>Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Copenhagen University Hospitals at Glostrup</institution>
,<addr-line>Glostrup</addr-line>
,<country>Denmark</country>
</nlm:aff>
<country xml:lang="fr">Danemark</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Zochling, Jane" sort="Zochling, Jane" uniqKey="Zochling J" first="Jane" last="Zochling">Jane Zochling</name>
<affiliation wicri:level="1"><nlm:aff id="af30"><institution>Menzies Research Institute Tasmania</institution>
,<addr-line>Hobart</addr-line>
,<country>Australia</country>
</nlm:aff>
<country xml:lang="fr">Australie</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Falzon, Louise" sort="Falzon, Louise" uniqKey="Falzon L" first="Louise" last="Falzon">Louise Falzon</name>
<affiliation wicri:level="1"><nlm:aff id="af31"><institution>Columbia University Medical Center</institution>
,<addr-line>New York, New York</addr-line>
,<country>USA</country>
</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
<author><name sortKey="Van Der Heijde, Desiree M" sort="Van Der Heijde, Desiree M" uniqKey="Van Der Heijde D" first="Désirée M" last="Van Der Heijde">Désirée M. Van Der Heijde</name>
<affiliation wicri:level="1"><nlm:aff id="af32"><institution>Leiden University Medical Center</institution>
,<addr-line>Leiden</addr-line>
,<country>The Netherlands</country>
</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea># see nlm:aff country strict</wicri:regionArea>
</affiliation>
</author>
</analytic>
<series><title level="j">Annals of the Rheumatic Diseases</title>
<idno type="ISSN">0003-4967</idno>
<idno type="eISSN">1468-2060</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><p>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.</p>
</div>
</front>
<back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Smith, Eu" uniqKey="Smith E">EU Smith</name>
</author>
<author><name sortKey="Diaz Torne, C" uniqKey="Diaz Torne C">C Diaz-Torne</name>
</author>
<author><name sortKey="Perez Ruiz, F" uniqKey="Perez Ruiz F">F Perez-Ruiz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Singh, Ja" uniqKey="Singh J">JA Singh</name>
</author>
<author><name sortKey="Strand, V" uniqKey="Strand V">V Strand</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Pascual, E" uniqKey="Pascual E">E Pascual</name>
</author>
<author><name sortKey="Sivera, F" uniqKey="Sivera F">F Sivera</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Roddy, E" uniqKey="Roddy E">E Roddy</name>
</author>
<author><name sortKey="Zhang, W" uniqKey="Zhang W">W Zhang</name>
</author>
<author><name sortKey="Doherty, M" uniqKey="Doherty M">M Doherty</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Perez Ruiz, F" uniqKey="Perez Ruiz F">F Perez-Ruiz</name>
</author>
<author><name sortKey="Carmona, L" uniqKey="Carmona L">L Carmona</name>
</author>
<author><name sortKey="Yebenes, Mj" uniqKey="Yebenes M">MJ Yebenes</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Doherty, M" uniqKey="Doherty M">M Doherty</name>
</author>
<author><name sortKey="Jansen, Tl" uniqKey="Jansen T">TL Jansen</name>
</author>
<author><name sortKey="Nuki, G" uniqKey="Nuki G">G Nuki</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zhang, W" uniqKey="Zhang W">W Zhang</name>
</author>
<author><name sortKey="Doherty, M" uniqKey="Doherty M">M Doherty</name>
</author>
<author><name sortKey="Pascual, E" uniqKey="Pascual E">E Pascual</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Zhang, W" uniqKey="Zhang W">W Zhang</name>
</author>
<author><name sortKey="Doherty, M" uniqKey="Doherty M">M Doherty</name>
</author>
<author><name sortKey="Pascual, E" uniqKey="Pascual E">E Pascual</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Khanna, D" uniqKey="Khanna D">D Khanna</name>
</author>
<author><name sortKey="Fitzgerald, Jd" uniqKey="Fitzgerald J">JD Fitzgerald</name>
</author>
<author><name sortKey="Khanna, Pp" uniqKey="Khanna P">PP Khanna</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Khanna, D" uniqKey="Khanna D">D Khanna</name>
</author>
<author><name sortKey="Khanna, Pp" uniqKey="Khanna P">PP Khanna</name>
</author>
<author><name sortKey="Fitzgerald, Jd" uniqKey="Fitzgerald J">JD Fitzgerald</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Hamburger, M" uniqKey="Hamburger M">M Hamburger</name>
</author>
<author><name sortKey="Baraf, Hs" uniqKey="Baraf H">HS Baraf</name>
</author>
<author><name sortKey="Adamson, Tc" uniqKey="Adamson T">TC Adamson</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Perez Ruiz, F" uniqKey="Perez Ruiz F">F Perez-Ruiz</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Grimshaw, Jm" uniqKey="Grimshaw J">JM Grimshaw</name>
</author>
<author><name sortKey="Thomas, Re" uniqKey="Thomas R">RE Thomas</name>
</author>
<author><name sortKey="Maclennan, G" uniqKey="Maclennan G">G MacLennan</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Visser, K" uniqKey="Visser K">K Visser</name>
</author>
<author><name sortKey="Katchamart, W" uniqKey="Katchamart W">W Katchamart</name>
</author>
<author><name sortKey="Loza, E" uniqKey="Loza E">E Loza</name>
</author>
</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Machado, P" uniqKey="Machado P">P Machado</name>
</author>
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</analytic>
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</analytic>
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</analytic>
</biblStruct>
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</analytic>
</biblStruct>
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<author><name sortKey="Mody, Rr" uniqKey="Mody R">RR Mody</name>
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</analytic>
</biblStruct>
<biblStruct><analytic><author><name sortKey="Perez Ruiz, F" uniqKey="Perez Ruiz F">F Perez-Ruiz</name>
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</analytic>
</biblStruct>
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<author><name sortKey="Barthelemy, Cr" uniqKey="Barthelemy C">CR Barthelemy</name>
</author>
<author><name sortKey="Veum, Ja" uniqKey="Veum J">JA Veum</name>
</author>
</analytic>
</biblStruct>
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</author>
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<author><name sortKey="Clayburne, G" uniqKey="Clayburne G">G Clayburne</name>
</author>
<author><name sortKey="Sieck, M" uniqKey="Sieck M">M Sieck</name>
</author>
</analytic>
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</author>
<author><name sortKey="Sivera, F" uniqKey="Sivera F">F Sivera</name>
</author>
</analytic>
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</author>
<author><name sortKey="Schumacher, Hr" uniqKey="Schumacher H">HR Schumacher</name>
</author>
<author><name sortKey="Benjamin, Kl" uniqKey="Benjamin K">KL Benjamin</name>
</author>
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</author>
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</author>
<author><name sortKey="Maranian, P" uniqKey="Maranian P">P Maranian</name>
</author>
</analytic>
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</author>
<author><name sortKey="Pelaez Ballestas, I" uniqKey="Pelaez Ballestas I">I Pelaez-Ballestas</name>
</author>
<author><name sortKey="Vazquez Mellado, J" uniqKey="Vazquez Mellado J">J Vazquez-Mellado</name>
</author>
</analytic>
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</author>
<author><name sortKey="Clark, B" uniqKey="Clark B">B Clark</name>
</author>
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</author>
</analytic>
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</author>
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</analytic>
</biblStruct>
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</author>
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</analytic>
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<li>Australie</li>
<li>Autriche</li>
<li>Belgique</li>
<li>Brésil</li>
<li>Canada</li>
<li>Danemark</li>
<li>Espagne</li>
<li>Italie</li>
<li>Mexique</li>
<li>Pays-Bas</li>
<li>Portugal</li>
<li>Royaume-Uni</li>
<li>Suède</li>
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<name sortKey="Landewe, Robert B" sort="Landewe, Robert B" uniqKey="Landewe R" first="Robert B" last="Landewé">Robert B. Landewé</name>
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<country name="États-Unis"><noRegion><name sortKey="Falzon, Louise" sort="Falzon, Louise" uniqKey="Falzon L" first="Louise" last="Falzon">Louise Falzon</name>
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