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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 27/10/2025

Gout goes beyond joints. Dr. Jasvinder Singh presents data linking gout to higher risks of myocardial infarction, vascular events, and atrial fibrillation, even when accounting for common comorbidities. Emerging evidence reinforces gout as a systemic disease impacting cardiovascular health. #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 27/10/2025

@natalie-mccor.bsky.social summarized that over half of people with gout also have metabolic syndrome, with insulin resistance driving hyperuricemia through reduced renal excretion. Lifestyle changes like weight loss and lower fructose intake can improve both gout and metabolic outcomes. #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 27/10/2025

Dr. Natalie McCormick adds how insulin resistance drives gout via decreased renal urate clearance. Elevated insulin enhances urate reabsorption through URAT1 and other transporters, linking metabolic dysfunction to hyperuricemia and gout risk. #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 27/10/2025

Dr. Natalie McCormick discusses how insulin resistance drives gout through both urate overproduction and underexcretion. Fructose intake plays a key role, rapidly increasing uric acid synthesis and gout risk with higher dietary consumption. #Gout #MetabolicSyndrome #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 27/10/2025

Dr. Natalie McCormick highlights that serum urate levels are strongly linked to metabolic syndrome burden. Hyperuricemia may serve as a surrogate marker of metabolic risk, suggesting urate could be considered a 6th MetS criterion. #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 27/10/2025

Live from #ACR25- Dr. Natalie McCormick is discussing the link between metabolic syndrome and gout, highlighting how insulin resistance and inflammation contribute to disease burden and outcomes.

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 25/10/2025

Dr. Angelo Gaffo emphasized that gout diagnosis relies on clinical presentation, serum urate, and imaging when available. Crystal confirmation is ideal but not always required. Context and tools matter. #ACR25 #gout #rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 25/10/2025

At #ACR25, Dr. Angelo Gaffo emphasized that serum urate can guide gout diagnosis, but timing matters. Levels often decrease during acute flares, underscoring the need for clinical context in interpreting sUA. #Gout #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

Dr. Tim Kwok emphasized that “difficult-to-treat gout” goes beyond urate levels, involving persistent inflammation, reduced function, and higher healthcare use. A holistic approach addressing clinical, patient, and system factors is key. #2025GCAN #Gout #Rheumatology

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 22/10/2025

Tim Kwok @uoftrheum.bsky.social on D2T gout, focusing on equity and who needs to get uricase based therapies The D2T concept started with RA, has taken hold of axSpA and PsA, and now gout enters the chat #GCAN2025 #ACR25

EULAR D2T RA 2019
ASAS difficult to manage axSpA 2025
GRAPPA D2T PsA in progress
GCAN D2T gout proposal

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 22/10/2025

BUT CLOAK, a colchicine in knee OA RCT was negative. Are we asking the wrong Q? Do we need a long duration on colchicine to detect tx benefit? LoDoCo2 posthoc: colchicine reduced risk of jt replacement #GCAN2025 #ACR25

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 22/10/2025

OA & gout: both related to chronic low level inflammation thru IL-1b Urate levels have been a/w OA progression & higher synovial fluid IL-1b levels in OA knees Is there benefit of colchicine in knee OA? #GCAN2025 #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

Dr. Michael Pillinger: Colchicine continues to show potential CV benefits in gout. Cipolletta et al. found lower short-term MI/stroke risk with colchicine during ULT initiation (HR 0.72). Yokose et al. showed colchicine safer than NSAIDs, though not vs placebo. #2025GCAN #Gout #Cardiology

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 22/10/2025

⭐Ben Hemming - UAB More on gout & CVD: recurrent MSU crystal injection induces macrophage protective tolerance. Studied in vivo (mice) and in vitro. #GCAN2025 #ACR25

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 22/10/2025

⭐Daniel Ward Phillips - UAB Focus on gout & CVD: how does inflammation from MSU crystals cause ASCVD? Studied in mice: fed a Western diet and injected with MSU crystals Unique inflam response from EMP1+ macrophage-like monocytes #GCAN2025 #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

Dr. Jason Yang: In STOP Gout, achieving SU < 6 mg/dL was linked to flares with lower pain intensity and shorter duration (esp. in pts w/o tophi). Flare characteristics may serve as early indicators of ULT efficacy beyond flare counts. #2025GCAN #Gout #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In the STOP Gout trial, 77% of pts achieved SU <6 mg/dL at or below the EasyAllo2-predicted allopurinol dose. Younger age, lower eGFR, and higher SU required higher doses, supporting EasyAllo2 for guided dose escalation. Dr. Brian Coburn #2025GCAN #Gout #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

Dr. Hyon Choi presents new data supporting treat-to-target urate lowering in gout. In a 10-year cohort (n=3,613), 95% of flares occurred with SU ≥6 mg/dL and 98% with SU ≥5 mg/dL. Flare rates rose sharply as SU increased, reinforcing the <6 mg/dL goal. #2025GCAN #Gout #Rheumatology

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 22/10/2025

Dr Hyon Choi (MGH Boston) #GCAN2025 on T2T ULT pragmatic trials in gout #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

AI is advancing crystal disease diagnosis. Deep learning models can now detect CPPD on hand radiographs, and machine learning of Raman spectra enables point-of-care identification of gout and CPPD. Dr. Geraldine McCarthy #2025GCAN #Rheumatology #AIinMedicine

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In a national VA cohort (18,761 CPPD pts, 75,043 controls), nephrolithiasis prevalence was higher in CPPD (8.6% vs 5.1%). Adjusted OR 1.65 supports CPPD as an independent risk factor for kidney stones and a systemic mineralization disorder. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In >20,000 matched patients aged ≥60, CPPD was linked to a 29% higher risk of any fracture across spine and limb sites over 85,000 patient-years. Risk was consistent in both men and women, supporting bone health screening in CPPD. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In a Mass General Brigham cohort (1991–2022), 756 CPPD patients had higher 10-year ASCVD risk scores vs matched controls, despite similar CAC burden. Findings suggest factors beyond CAC contribute to elevated CV risk in CPPD. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

From 20-year and 7-year cohort data, chondrocalcinosis was present in 5% at baseline and linked to higher odds of incident knee OA (OR 1.75). No consistent association with knee pain. CC may represent a distinct OA subtype. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In 51 patients with OA, ultrasound outperformed radiography for detecting CPPD (accuracy 0.78 vs 0.73). Combining both modalities added value only in select cases. US alone was more reliable for CPPD identification. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In a community cohort of 861, knee US detected calcium crystals in 13% of cases, linked to over 50% higher odds of moderate/severe pain and 60% higher odds of radiographic KOA. US-based diagnosis shows promise for broader KOA assessment. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

Hip ultrasound shows strong accuracy for detecting CPPD. In 100 hip replacement patients, US sensitivity was 90%, specificity 82%, and AUC 0.86 compared with histopathology, supporting US as a reliable tool for hip CPPD detection. Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

The largest gout GWAS to date (2.6M people, 120k gout cases) identified 377 loci (149 new), including 22 linked to gout inflammation independent of urate. Pathways span cytokine signaling, epigenetic remodeling, and CHIP (TET2) with causal links to gout. – Dr. Isidoro Cobo #2025GCAN

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

The burden of gout flares remains high. Patients averaged 6.6 flares per year, and 72% of flares were unreported, pretreated, or prevented, highlighting major underrecognition of disease activity. – Dr. Edoardo Cipolletta #2025GCAN #GoutAwareness #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

AI in managing gout In a 4-yr study of 2,670 pts, an AI-based gout management system led to lower CKD stage ≥3 incidence (HR 0.57) and higher SU goal attainment (49.8% vs 25.9%) vs standard care. – Dr. Edoardo Cipolletta #2025GCAN #Rheumatology #GoutAwareness

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Thang Le, PharmD, MBA, BCPS, RPh @rxthangle.bsky.social · 22/10/2025

In 2025, Gout remains undertreated. Among gout+CKD pts starting ULT, only 48.3% had SU checked in 6mo & 54.3% had no dose change. In hospitalized pts, SU measured in 16.3%; 43.1% >target; 80% had dose unchanged/reduced. – Dr. Edoardo Cipolletta #2025GCAN #GoutAwareness

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