Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout

David Bursill; William J. Taylor; Robert Terkeltaub; Abhishek Abhishek; Alexander K. So; Ana Beatriz Vargas-Santos; Angelo Lino Gaffo; Ann Rosenthal; Anne-Kathrin Tausche; Anthony Reginato; Bernhard Manger; Carlo Scire; Carlos Pineda; Caroline van Durme; Ching-Tsai Lin; Congcong Yin; Daniel Arthur Albert; Edyta Biernat-Kaluza; Edward Roddy; Eliseo Pascual; Fabio Becce; Fernando Perez-Ruiz; Francisca Sivera; Frederic Liote; Georg Schett; George Nuki; Georgios Filippou; Geraldine McCarthy; Geraldo da Rocha Castelar Pinheiro; Hang-Korng Ea; Helena De Almeida Tupinamba; Hisashi Yamanaka; Hyon K. Choi; James Mackay; James R. ODell; Janitzia Vazquez Mellado; Jasvinder A. Singh; John D. Fitzgerald; Lennart T. H. Jacobsson; Leo Joosten; Leslie R. Harrold; Lisa Stamp; Mariano Andres; Marwin Gutierrez; Masanari Kuwabara; Mats Dehlin; Matthijs Janssen; Michael Doherty; Michael S. Hershfield; Michael Pillinger; N. Lawrence Edwards; Naomi Schlesinger; Nitin Kumar; Ole Slot; Sebastien Ottaviani; Pascal Richette; Paul A. MacMullan; Peter T. Chapman; Peter E. Lipsky; Philip Robinson; Puja P. Khanna; Rada N. Gancheva; Rebecca Grainger; Richard J. Johnson; Ritch Te Kampe; Robert T. Keenan; Sara K. Tedeschi; Seoyoung Kim; Sung Jae Choi; Theodore R. Fields; Thomas Bardin; Till Uhlig; Tim Jansen; Tony Merriman; Tristan Pascart; Tuhina Neogi; Viola Kluck; Worawit Louthrenoo; Nicola Dalbeth

doi:10.1136/annrheumdis-2019-215933

Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout

David Bursill^*, William J. Taylor, Robert Terkeltaub, Abhishek Abhishek, Alexander K. So, Ana Beatriz Vargas-Santos, Angelo Lino Gaffo, Ann Rosenthal, Anne-Kathrin Tausche, Anthony Reginato, Bernhard Manger, Carlo Scire, Carlos Pineda, Caroline van Durme, Ching-Tsai Lin, Congcong Yin, Daniel Arthur Albert, Edyta Biernat-Kaluza, Edward Roddy, Eliseo PascualFabio Becce, Fernando Perez-Ruiz, Francisca Sivera, Frederic Liote, Georg Schett, George Nuki, Georgios Filippou, Geraldine McCarthy, Geraldo da Rocha Castelar Pinheiro, Hang-Korng Ea, Helena De Almeida Tupinamba, Hisashi Yamanaka, Hyon K. Choi, James Mackay, James R. ODell, Janitzia Vazquez Mellado, Jasvinder A. Singh, John D. Fitzgerald, Lennart T. H. Jacobsson, Leo Joosten, Leslie R. Harrold, Lisa Stamp, Mariano Andres, Marwin Gutierrez, Masanari Kuwabara, Mats Dehlin, Matthijs Janssen, Michael Doherty, Michael S. Hershfield, Michael Pillinger, N. Lawrence Edwards, Naomi Schlesinger, Nitin Kumar, Ole Slot, Sebastien Ottaviani, Pascal Richette, Paul A. MacMullan, Peter T. Chapman, Peter E. Lipsky, Philip Robinson, Puja P. Khanna, Rada N. Gancheva, Rebecca Grainger, Richard J. Johnson, Ritch Te Kampe, Robert T. Keenan, Sara K. Tedeschi, Seoyoung Kim, Sung Jae Choi, Theodore R. Fields, Thomas Bardin, Till Uhlig, Tim Jansen, Tony Merriman, Tristan Pascart, Tuhina Neogi, Viola Kluck, Worawit Louthrenoo, Nicola Dalbeth

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.

Methods A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.

Results The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).

Conclusion Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

Original language	English
Pages (from-to)	1592-1600
Number of pages	9
Journal	Annals of the Rheumatic Diseases
Volume	78
Issue number	11
DOIs	https://doi.org/10.1136/annrheumdis-2019-215933
Publication status	Published - Nov 2019

Keywords

EVIDENCE-BASED RECOMMENDATIONS
MANAGEMENT

Access to Document

10.1136/annrheumdis-2019-215933

Cite this

Bursill, D., Taylor, W. J., Terkeltaub, R., Abhishek, A., So, A. K., Vargas-Santos, A. B., Gaffo, A. L., Rosenthal, A., Tausche, A.-K., Reginato, A., Manger, B., Scire, C., Pineda, C., van Durme, C., Lin, C.-T., Yin, C., Albert, D. A., Biernat-Kaluza, E., Roddy, E., ... Dalbeth, N. (2019). Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. Annals of the Rheumatic Diseases, 78(11), 1592-1600. https://doi.org/10.1136/annrheumdis-2019-215933

@article{ee543fca4e584c5dbf45b48c8041901c,

title = "Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout",

abstract = "Objective There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.Methods A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.Results The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).Conclusion Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.",

keywords = "EVIDENCE-BASED RECOMMENDATIONS, MANAGEMENT",

author = "David Bursill and Taylor, {William J.} and Robert Terkeltaub and Abhishek Abhishek and So, {Alexander K.} and Vargas-Santos, {Ana Beatriz} and Gaffo, {Angelo Lino} and Ann Rosenthal and Anne-Kathrin Tausche and Anthony Reginato and Bernhard Manger and Carlo Scire and Carlos Pineda and {van Durme}, Caroline and Ching-Tsai Lin and Congcong Yin and Albert, {Daniel Arthur} and Edyta Biernat-Kaluza and Edward Roddy and Eliseo Pascual and Fabio Becce and Fernando Perez-Ruiz and Francisca Sivera and Frederic Liote and Georg Schett and George Nuki and Georgios Filippou and Geraldine McCarthy and {Castelar Pinheiro}, {Geraldo da Rocha} and Hang-Korng Ea and Tupinamba, {Helena De Almeida} and Hisashi Yamanaka and Choi, {Hyon K.} and James Mackay and ODell, {James R.} and {Vazquez Mellado}, Janitzia and Singh, {Jasvinder A.} and Fitzgerald, {John D.} and Jacobsson, {Lennart T. H.} and Leo Joosten and Harrold, {Leslie R.} and Lisa Stamp and Mariano Andres and Marwin Gutierrez and Masanari Kuwabara and Mats Dehlin and Matthijs Janssen and Michael Doherty and Hershfield, {Michael S.} and Michael Pillinger and Edwards, {N. Lawrence} and Naomi Schlesinger and Nitin Kumar and Ole Slot and Sebastien Ottaviani and Pascal Richette and MacMullan, {Paul A.} and Chapman, {Peter T.} and Lipsky, {Peter E.} and Philip Robinson and Khanna, {Puja P.} and Gancheva, {Rada N.} and Rebecca Grainger and Johnson, {Richard J.} and {Te Kampe}, Ritch and Keenan, {Robert T.} and Tedeschi, {Sara K.} and Seoyoung Kim and Choi, {Sung Jae} and Fields, {Theodore R.} and Thomas Bardin and Till Uhlig and Tim Jansen and Tony Merriman and Tristan Pascart and Tuhina Neogi and Viola Kluck and Worawit Louthrenoo and Nicola Dalbeth",

note = "Funding Information: Competing interests aKT has received speaking fees and honoraria for advisory boards from Berlin Chemie Menarini, novartis, Gr{\"u}nenthal and astraZeneca. Jas has received consultant fees from Crealta/Horizon, Medisys, Fidia, UBM llC, Medscape, WebMD, the national institutes of Health and the american College of Rheumatology. Jas owns stock options in amarin pharmaceuticals and Viking therapeutics. Jas is a member of the executive of OMeRaCT, an organisation that develops outcome measures in rheumatology and receives arms-length funding from 36 companies. Jas is a member of the Veterans affairs Rheumatology Field advisory Committee. Jas is the editor and the Director of the UaB Cochrane Musculoskeletal Group satellite Center on network Meta-analysis. Jas previously served as a member of the following committees: member, the american College of Rheumatology{\textquoteright}s (aCR) annual Meeting Planning Committee (aMPC) and Quality of Care Committees, the Chair of the aCR Meet-the-Professor, Workshop and study Group subcommittee and the co-chair of the aCR Criteria and Response Criteria subcommittee. nD has received speaking fees from Pfizer, Horizon, Janssen, and abbVie, consulting fees from Horizon, astraZeneca, Dyve Biosciences, Hengrui, and Kowa, and research funding from amgen and astraZeneca. Funding Information: Work by DB was supported by an Australian Rheumatology Association/Arthritis South Australia Post-Graduate Rheumatology grant.RT reports research grants from the VA Research Service (I01 BX001660-06), NIH (AR060772). Publisher Copyright: {\textcopyright} Author(s) (or their employer(s)) 2019.",

year = "2019",

month = nov,

doi = "10.1136/annrheumdis-2019-215933",

language = "English",

volume = "78",

pages = "1592--1600",

journal = "Annals of the Rheumatic Diseases",

issn = "0003-4967",

publisher = "BMJ Publishing Group",

number = "11",

}

Bursill, D, Taylor, WJ, Terkeltaub, R, Abhishek, A, So, AK, Vargas-Santos, AB, Gaffo, AL, Rosenthal, A, Tausche, A-K, Reginato, A, Manger, B, Scire, C, Pineda, C, van Durme, C, Lin, C-T, Yin, C, Albert, DA, Biernat-Kaluza, E, Roddy, E, Pascual, E, Becce, F, Perez-Ruiz, F, Sivera, F, Liote, F, Schett, G, Nuki, G, Filippou, G, McCarthy, G, Castelar Pinheiro, GDR, Ea, H-K, Tupinamba, HDA, Yamanaka, H, Choi, HK, Mackay, J, ODell, JR, Vazquez Mellado, J, Singh, JA, Fitzgerald, JD, Jacobsson, LTH, Joosten, L, Harrold, LR, Stamp, L, Andres, M, Gutierrez, M, Kuwabara, M, Dehlin, M, Janssen, M, Doherty, M, Hershfield, MS, Pillinger, M, Edwards, NL, Schlesinger, N, Kumar, N, Slot, O, Ottaviani, S, Richette, P, MacMullan, PA, Chapman, PT, Lipsky, PE, Robinson, P, Khanna, PP, Gancheva, RN, Grainger, R, Johnson, RJ, Te Kampe, R, Keenan, RT, Tedeschi, SK, Kim, S, Choi, SJ, Fields, TR, Bardin, T, Uhlig, T, Jansen, T, Merriman, T, Pascart, T, Neogi, T, Kluck, V, Louthrenoo, W & Dalbeth, N 2019, 'Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout', Annals of the Rheumatic Diseases, vol. 78, no. 11, pp. 1592-1600. https://doi.org/10.1136/annrheumdis-2019-215933

Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout. / Bursill, David; Taylor, William J.; Terkeltaub, Robert et al.
In: Annals of the Rheumatic Diseases, Vol. 78, No. 11, 11.2019, p. 1592-1600.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Gout, Hyperuricaemia and Crystal-Associated Disease Network (G-CAN) consensus statement regarding labels and definitions of disease states of gout

AU - Bursill, David

AU - Taylor, William J.

AU - Terkeltaub, Robert

AU - Abhishek, Abhishek

AU - So, Alexander K.

AU - Vargas-Santos, Ana Beatriz

AU - Gaffo, Angelo Lino

AU - Rosenthal, Ann

AU - Tausche, Anne-Kathrin

AU - Reginato, Anthony

AU - Manger, Bernhard

AU - Scire, Carlo

AU - Pineda, Carlos

AU - van Durme, Caroline

AU - Lin, Ching-Tsai

AU - Yin, Congcong

AU - Albert, Daniel Arthur

AU - Biernat-Kaluza, Edyta

AU - Roddy, Edward

AU - Pascual, Eliseo

AU - Becce, Fabio

AU - Perez-Ruiz, Fernando

AU - Sivera, Francisca

AU - Liote, Frederic

AU - Schett, Georg

AU - Nuki, George

AU - Filippou, Georgios

AU - McCarthy, Geraldine

AU - Castelar Pinheiro, Geraldo da Rocha

AU - Ea, Hang-Korng

AU - Tupinamba, Helena De Almeida

AU - Yamanaka, Hisashi

AU - Choi, Hyon K.

AU - Mackay, James

AU - ODell, James R.

AU - Vazquez Mellado, Janitzia

AU - Singh, Jasvinder A.

AU - Fitzgerald, John D.

AU - Jacobsson, Lennart T. H.

AU - Joosten, Leo

AU - Harrold, Leslie R.

AU - Stamp, Lisa

AU - Andres, Mariano

AU - Gutierrez, Marwin

AU - Kuwabara, Masanari

AU - Dehlin, Mats

AU - Janssen, Matthijs

AU - Doherty, Michael

AU - Hershfield, Michael S.

AU - Pillinger, Michael

AU - Edwards, N. Lawrence

AU - Schlesinger, Naomi

AU - Kumar, Nitin

AU - Slot, Ole

AU - Ottaviani, Sebastien

AU - Richette, Pascal

AU - MacMullan, Paul A.

AU - Chapman, Peter T.

AU - Lipsky, Peter E.

AU - Robinson, Philip

AU - Khanna, Puja P.

AU - Gancheva, Rada N.

AU - Grainger, Rebecca

AU - Johnson, Richard J.

AU - Te Kampe, Ritch

AU - Keenan, Robert T.

AU - Tedeschi, Sara K.

AU - Kim, Seoyoung

AU - Choi, Sung Jae

AU - Fields, Theodore R.

AU - Bardin, Thomas

AU - Uhlig, Till

AU - Jansen, Tim

AU - Merriman, Tony

AU - Pascart, Tristan

AU - Neogi, Tuhina

AU - Kluck, Viola

AU - Louthrenoo, Worawit

AU - Dalbeth, Nicola

N1 - Funding Information: Competing interests aKT has received speaking fees and honoraria for advisory boards from Berlin Chemie Menarini, novartis, Grünenthal and astraZeneca. Jas has received consultant fees from Crealta/Horizon, Medisys, Fidia, UBM llC, Medscape, WebMD, the national institutes of Health and the american College of Rheumatology. Jas owns stock options in amarin pharmaceuticals and Viking therapeutics. Jas is a member of the executive of OMeRaCT, an organisation that develops outcome measures in rheumatology and receives arms-length funding from 36 companies. Jas is a member of the Veterans affairs Rheumatology Field advisory Committee. Jas is the editor and the Director of the UaB Cochrane Musculoskeletal Group satellite Center on network Meta-analysis. Jas previously served as a member of the following committees: member, the american College of Rheumatology’s (aCR) annual Meeting Planning Committee (aMPC) and Quality of Care Committees, the Chair of the aCR Meet-the-Professor, Workshop and study Group subcommittee and the co-chair of the aCR Criteria and Response Criteria subcommittee. nD has received speaking fees from Pfizer, Horizon, Janssen, and abbVie, consulting fees from Horizon, astraZeneca, Dyve Biosciences, Hengrui, and Kowa, and research funding from amgen and astraZeneca. Funding Information: Work by DB was supported by an Australian Rheumatology Association/Arthritis South Australia Post-Graduate Rheumatology grant.RT reports research grants from the VA Research Service (I01 BX001660-06), NIH (AR060772). Publisher Copyright: © Author(s) (or their employer(s)) 2019.

PY - 2019/11

Y1 - 2019/11

N2 - Objective There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.Methods A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.Results The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).Conclusion Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

AB - Objective There is a lack of standardisation in the terminology used to describe gout. The aim of this project was to develop a consensus statement describing the recommended nomenclature for disease states of gout.Methods A content analysis of gout-related articles from rheumatology and general internal medicine journals published over a 5-year period identified potential disease states and the labels commonly assigned to them. Based on these findings, experts in gout were invited to participate in a Delphi exercise and face-to-face consensus meeting to reach agreement on disease state labels and definitions.Results The content analysis identified 13 unique disease states and a total of 63 unique labels. The Delphi exercise (n=76 respondents) and face-to-face meeting (n=35 attendees) established consensus agreement for eight disease state labels and definitions. The agreed labels were as follows: 'asymptomatic hyperuricaemia', 'asymptomatic monosodium urate crystal deposition', 'asymptomatic hyperuricaemia with monosodium urate crystal deposition', 'gout', 'tophaceous gout', 'erosive gout', 'first gout flare' and 'recurrent gout flares'. There was consensus agreement that the label 'gout' should be restricted to current or prior clinically evident disease caused by monosodium urate crystal deposition (gout flare, chronic gouty arthritis or subcutaneous tophus).Conclusion Consensus agreement has been established for the labels and definitions of eight gout disease states, including 'gout' itself. The Gout, Hyperuricaemia and Crystal-Associated Disease Network recommends the use of these labels when describing disease states of gout in research and clinical practice.

KW - EVIDENCE-BASED RECOMMENDATIONS

KW - MANAGEMENT

U2 - 10.1136/annrheumdis-2019-215933

DO - 10.1136/annrheumdis-2019-215933

M3 - Article

C2 - 31501138

SN - 0003-4967

VL - 78

SP - 1592

EP - 1600

JO - Annals of the Rheumatic Diseases

JF - Annals of the Rheumatic Diseases

IS - 11

ER -