Gout

Association between gout and cancers: A systematic review and meta-analysis.

Tian L, Wang Y, Zhang Y, Tian L, Wang H · Medicine · 2024 · n=804

This study aimed to investigate the association between gout and cancer risk. This study was registered with the Prospective Registry for International Systematic Reviews (ID: CRD42023465587). We searched PubMed, Embase, Scopus, Cochrane, and Web of Science databases for studies related to gout and cancer risk, with a timeframe from the date the database was created to September 2023. We assessed the methodological quality of the included studies using the Newcastle-Ottawa scale and assessed heterogeneity between studies using the I2 statistic. Depending on the heterogeneity, we calculated pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) using fixed-effects or random-effects models. In addition, we performed sensitivity analyses and publication bias tests. In this study, we conducted a meta-analysis of 6 studies encompassing a total of 1279,804 participants. Our analysis revealed that individuals with gout are at a heightened risk of developing cancer in ge

Meta-analysis and systematic review of gout prevalence in the heart/lung transplantation population.

Chui B, Day R, Umashankar E, Abdel Shaheed C, Keogh A, Girgis L · Frontiers in transplantation · 2024

Gout may complicate solid organ transplantation with potentially serious consequences. An accurate prevalence of gout in this population is unknown. This study aimed to estimate the prevalence of gout in the heart and/or lung transplantation population through a systematic review and meta-analysis. MEDLINE, Embase, PsycINFO, CENTRAL and Cochrane Library (inception to February 2022) were searched for studies that reported the prevalence and/or incidence of gout in heart and/or lung transplant recipients. Two authors extracted outcomes data. Data were pooled using a random effects model. Overall quality of evidence was assessed using GRADE. Primary outcomes were the prevalence of pre- or post-transplant gout expressed as a prevalence rate (95% CI). Secondary outcomes included risk factors for gout, adverse events, and therapeutic complications of gout treatment. Ten studies were included. Gout prevalence (PR) was 8% pre-transplant (PR = 0.08; 95% CI: 0.05-0.12; 4 studies

Effects of dietary factors on hyperuricaemia and gout: a systematic review and meta-analysis of observational studies.

Chi X, Cen Y, Yang B, Zhang H, Pu Z, Feng J · International journal of food sciences and nutrition · 2024

This study aimed to gather the best evidence on the relationship between dietary factors and hyperuricaemia and gout. We searched databases including PubMed, Embase, Cochrane, and Web of Science from database creation to July 2023. Meta-analysis showed that consumption of alcohol (OR: 1.41, 95% CI: 1.29-1.55; 1.60, 95% CI: 1.33-1.93, respectively), red meat (OR:1.27, 95% CI: 1.18-1.37; 1.32, 95% CI: 1.18-1.47, respectively), fructose (OR: 1.29, 95% CI: 1.21-1.38; 1.65, 95% CI: 1.36-2.01, respectively) and seafoods (OR: 1.40, 95% CI: 1.20-1.64; 1.29, 95% CI: 1.00-1.67, respectively) were positively associated with the risk of hyperuricaemia and gout, while vegetables (OR: 0.78, 95% CI: 0.71-0.85; 0.96,95% CI 0.74-1.24, respectively) were inversely associated. Dairy products (OR: 0.69, 95% CI: 0.61-0.78) and nuts (OR: 0.75, 95% CI: 0.60-0.93) were also inversely associated with the risk of hyperuricaemia. Soy products (OR: 0.86, 95% CI: 0.75-0.98) and coffee (OR: 0.56, 95% CI:

Clostridium butyricum and its metabolites regulate macrophage polarization through miR-146a to antagonize gouty arthritis.

Song S, Shi K, Fan M, Wen X, Li J, Guo Y · Journal of advanced research · 2026

Gut microbiota modulation has recently been identified as a prospective avenue for the exploration of novel therapeutic strategies for the management of gout. Nevertheless, the application of a single specific strain or bacterial metabolite for gout intervention has rarely been explored and the underlying regulatory mechanism remains elusive. To ascertain the potential role and the molecular mechanism of Clostridium butyricum and butyrate in the management of gouty arthritis. A Uox-KO mouse model of gouty arthritis was developed and the composition of the gut microbiota was analyzed. C. butyricum and butyrate were supplemented to assess functional recovery and intestinal homeostasis. NanoString analysis identified miRNA variations. GC/MS measured butyric acid levels and qPCR detected the abundance of butyrate-producing enzymes and bacteria. Flow cytometry analyzed macrophage polarization and ELISA measured pro-inflammatory cytokine production. Agomir and antagomir were transfected an

Risk factors for nephrolithiasis formation: an umbrella review.

Ma Y, Cheng C, Jian Z, Wen J, Xiang L, Li H · International journal of surgery (London, England) · 2024

Nephrolithiasis is prevalent and burdensome worldwide. At present, evidence on the risk factors for nephrolithiasis is unconsolidated and the associations remain uncertain. The authors systematically evaluate the robustness of the meta-analytic evidence and aid more reliable interpretations of the epidemiological relationships. The authors conducted a comprehensive review of the meta-analyses, screened the included studies with the aid of the AMSTAR 2 evaluation tool, and then used R (4.1.1) software to perform data analysis to evaluate the association between candidate risk factors and kidney stones, and evaluated the credibility of the evidence of the association between risk factors and kidney stones according to the GRADE classification, and finally obtained the strength and effectiveness of the association. The authors finally included 17 meta-analyses regarding 46 risk factors, 34 of which (73.9%) showed statistically significant association with nephrolithiasis. Among the sign

Dietary sugar consumption and health: umbrella review.

Huang Y, Chen Z, Chen B, Li J, Yuan X, Li J · BMJ (Clinical research ed.) · 2023

To evaluate the quality of evidence, potential biases, and validity of all available studies on dietary sugar consumption and health outcomes. Umbrella review of existing meta-analyses. PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and hand searching of reference lists. Systematic reviews and meta-analyses of randomised controlled trials, cohort studies, case-control studies, or cross sectional studies that evaluated the effect of dietary sugar consumption on any health outcomes in humans free from acute or chronic diseases. The search identified 73 meta-analyses and 83 health outcomes from 8601 unique articles, including 74 unique outcomes in meta-analyses of observational studies and nine unique outcomes in meta-analyses of randomised controlled trials. Significant harmful associations between dietary sugar consumption and 18 endocrine/metabolic outcomes, 10 cardiovascular outcomes, seven cancer outcomes, and 10 other outcomes (neuropsychiatric, dental,

2024 Update of Chinese Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout Part I: Recommendations for General Patients.

Sun M, Lyu Z, Wang C, Li Y, Zhao D, Ran X · International journal of rheumatic diseases · 2025

In 2018, the Chinese Society of Endocrinology developed the "Chinese guideline for diagnosis and treatment of hyperuricemia and gout (2019)". Over the past 5 years, clinical and experimental research has expanded our knowledge of gout, resulting in novel diagnostic and therapeutic approaches. This update, prompted by new clinical challenges and gaps in evidence, aims to refine the 2019 guidelines. The working group formulated clinical questions based on a nationwide questionnaire survey, and the expert panel evaluated new evidence addressing these questions from January 2019 to March 2025. The guideline development followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, adhering to internationally recognized protocols for clinical practice guideline development. The update includes 26 recommendations addressing 10 clinical questions related to urate-lowering therapy (ULT) for asymptomatic hyperuricemia and reproductive populations, ant

2024 Update of Chinese Guidelines for Management of Hyperuricemia and Gout Part II: Recommendations for Patients With Common Comorbidities.

Li C, Sun M, Liu Z, Li D, Wang C, Tian Z · International journal of rheumatic diseases · 2025

The aim of this updated guideline is to provide comprehensive recommendations for the management of gout in patients with common comorbidities, such as chronic kidney disease (CKD), cardiovascular disease (CVD), diabetes, osteoarthritis (OA), and gastrointestinal disorders. This guideline was developed by a multidisciplinary expert panel consisting of specialists in endocrinology, rheumatology, nephrology, cardiology, gastroenterology, and methodology. The development process adhered to standard methodologies, including PICO (population, intervention, comparator, and outcomes) question deconstruction, systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation (GRADE) for evidence and recommendation evaluation, Delphi voting, and expert consensus. The guideline presents 26 evidence-based recommendations addressing seven clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the m

2023 EULAR recommendations on imaging in diagnosis and management of crystal-induced arthropathies in clinical practice.

Mandl P, D'Agostino MA, Navarro-Compán V, Geßl I, Sakellariou G, Abhishek A · Annals of the rheumatic diseases · 2024

To formulate evidence-based recommendations and overarching principles on the use of imaging in the clinical management of crystal-induced arthropathies (CiAs). An international task force of 25 rheumatologists, radiologists, methodologists, healthcare professionals and patient research partners from 11 countries was formed according to the EULAR standard operating procedures. Fourteen key questions on the role of imaging in the most common forms of CiA were generated. The CiA assessed included gout, calcium pyrophosphate deposition disease and basic calcium phosphate deposition disease. Imaging modalities included conventional radiography, ultrasound, CT and MRI. Experts applied research evidence obtained from four systematic literature reviews using MEDLINE, EMBASE and CENTRAL. Task force members provided level of agreement (LoA) anonymously by using a Numerical Rating Scale from 0 to 10. Five overarching principles and 10 recommendations were developed encompassing the role of ima

Efficacy and safety of tart cherry supplementary citrate mixture on gout patients: a prospective, randomized, controlled study.

Wang C, Sun W, Dalbeth N, Wang Z, Wang X, Ji X · Arthritis research & therapy · 2023 · n=282

Low urine pH, which may be mediated by metabolic syndrome (MetS), is common in gout. Tart cherries are shown to improve MetS symptoms and possess anti-inflammatory properties. However, the efficacy of tart cherry supplements on urine pH has yet to be studied. This study aimed to investigate the efficacy and safety of tart cherry supplementary citrate (TaCCi) mixture on urine pH, serum urate (sUA), C-reactive protein (CRP), and gout flares in gout patients initiating urate-lowering therapy (ULT), in comparison to citrate mixture and sodium bicarbonate. A prospective, randomized (1:1:1), open-label, parallel-controlled trial was conducted among 282 men with gout and fasting urine pH ≤ 6, who were initiating ULT with febuxostat (initially 20 mg daily, escalating to 40 mg daily if serum urate ≥ 360 μmol/L). Participants were randomized to groups taking either sodium bicarbonate, citrate mixture, or TaCCi mixture. All particip

Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials.

Sundy JS, Baraf HS, Yood RA, Edwards NL, Gutierrez-Urena SR, Treadwell EL · JAMA · 2011 · n=225

Patients with chronic disabling gout refractory to conventional urate-lowering therapy need timely treatment to control disease manifestations related to tissue urate crystal deposition. Pegloticase, monomethoxypoly(ethylene glycol)-conjugated mammalian recombinant uricase, was developed to fulfill this need. To assess the efficacy and tolerability of pegloticase in managing refractory chronic gout. Two replicate, randomized, double-blind, placebo-controlled trials (C0405 and C0406) were conducted between June 2006 and October 2007 at 56 rheumatology practices in the United States, Canada, and Mexico in patients with severe gout, allopurinol intolerance or refractoriness, and serum uric acid concentration of 8.0 mg/dL or greater. A total of 225 patients participated: 109 in trial C0405 and 116 in trial C0406. Twelve biweekly intravenous infusions containing either pegloticase 8 mg at each infusion (biweekly treatment group), pegloticase alternating with placebo at successive infusio

Febuxostat compared with allopurinol in patients with hyperuricemia and gout.

Becker MA, Schumacher HR Jr, Wortmann RL, MacDonald PA, Eustace D, Palo WA · The New England journal of medicine · 2005 · n=762

Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase, is a potential alternative to allopurinol for patients with hyperuricemia and gout. We randomly assigned 762 patients with gout and with serum urate concentrations of at least 8.0 mg per deciliter (480 micromol per liter) to receive either febuxostat (80 mg or 120 mg) or allopurinol (300 mg) once daily for 52 weeks; 760 received the study drug. Prophylaxis against gout flares with naproxen or colchicine was provided during weeks 1 through 8. The primary end point was a serum urate concentration of less than 6.0 mg per deciliter (360 micromol per liter) at the last three monthly measurements. The secondary end points included reduction in the incidence of gout flares and in tophus area. The primary end point was reached in 53 percent of patients receiving 80 mg of febuxostat, 62 percent of those receiving 120 mg of febuxostat, and 21 percent of those receiving allopurinol (P<0.001 for the comparison of each febu

Biological aging and gout risk in hyperuricemia: a UK Biobank cohort study.

Li N, Chen Z, Han M, Shang A, Zhou J, Sun YX · International journal of surgery (London, England) · 2026 · n=493

To investigate the role of biological aging in the progression from hyperuricemia to gout and to evaluate whether an antiaging diet can prevent this progression. This prospective study involved 412 493 participants from the UK Biobank. Multiple regression models were employed to assess the associations, while Mendelian Randomization was utilized to explore causality. Additionally, the composite dietary antioxidant index (CDAI) was evaluated to examine its preventive effects. Biological aging acceleration was associated with higher level of serum uric acid by an average of 8.1 μmol/l (95% CI: 7.6-8.7, P < 0.001), 40% increased odds of developing hyperuricemia (OR 1.4, 95% CI: 1.36-1.43, P < 0.001), and 39% increased odds of gout (OR 1.39, 95% CI: 1.32-1.46, P < 0.001). Among the hyperuricemia population, accelerated biological aging participants had a 14% increased odds of developing gout compared with participants with delayed biological aging

Rheumatoid arthritis and gout: a rare combination or overlooked coexistence?

Li S, Zhao Q, Cai X, He X, Li S, Chen Z · Arthritis research & therapy · 2026

Rheumatoid arthritis (RA) and gout are traditionally considered distinct diseases with differing pathogenic mechanisms, making their coexistence controversial. Emerging evidence suggests this overlap may be underestimated. This study aimed to evaluate their epidemiological association, genetic causality, and intersecting molecular features. Epidemiological analyses used National Health and Nutrition Examination Survey (NHANES; 2007 ~ 2018, n = 19,705) data. Propensity score matching and weighted multivariate logistic regression assessed gout prevalence, temporal trends, and risk factors in RA. Restricted cubic spline (RCS) analysis examined nonlinear serum urate (SUA)-gout associations within RA. Mendelian randomization (MR) analyses based on genome-wide association study (GWAS) data evaluated causal effects of overall RA, Seronegative RA (SNRA), and Seropositive RA (SPRA) on gout and SUA, with multiple testing controlled by Bonferroni correction. Transcrip

Dietary polyunsaturated fatty acid and risk of gout: a cohort study integrating genetic predisposition and metabolomics.

Chen L, Tan T, Wu Q, Cui F, Chen Y, Chen H · European journal of epidemiology · 2025 · n=33

Gout is the most common inflammatory arthritis and affects quality of life. Dietary polyunsaturated fatty acids (PUFAs) have protective effects against various diseases, but its role in gout remains uncertain. Our study aims to assess the association between PUFAs intake and gout risk, the role of genetic factors, and the possible impact of metabolites. This study included 198,033 participants who were free of gout at baseline and completed at least one reliable dietary assessment in the UK Biobank. Cox proportional hazard models were used to estimate the associations between PUFAs intake and gout risk, and the modified effects of genetic predisposition. Mediation analysis also explored the mediating role of metabolic signature in associations between specific PUFAs intake and gout. Over a median follow-up of 9.47 years, 1,708 incident cases of gout were recorded. Gout risk was significantly associated with the second quartile of linoleic acid (LA) (0.86 [0.75, 1.00]) intake and the

Gout

NHS

The NHS provides an overview of gout, explaining what it is, its symptoms, causes, and how it's diagnosed. It also covers treatment options, including self-help tips and when to see a GP.

A Multi-Center Phase 2/3 Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Safety and Efficacy Study of Dapansutrile Tablets in Subjects With an Acute Gout Flare

n=300 · NCT05658575 · RECRUITING · RECRUITING

The purpose of this trial is to investigate the efficacy and safety of dapansutrile (OLT1177®) tablets in subjects with an acute gout flare.

Multicentre Prospective Observational Study for Identification of Determinants of Disability and Quality of Life in Patients With Gout.

n=450 · NCT01549210 · COMPLETED · COMPLETED

The study aims to identify which characteristics are associated with disability and poor quality of life in patients suffering from gout. This is a multicentre prospective observational study carried out in a cohort of Italian patients with gout. Subjects are randomly selected from a list of patients referred to each participant rheumatology clinic in the previous 2 years. Clinical evaluations are performed at baseline, at 6 and 12 months; data are retrieved about sociodemographic variables, life-styles, history of gout, comorbidities and patterns of treatment. At each visit patients complete questionnaires assessing disability and health-related quality of life. Preplanned analyses will be performed to investigate predictors of disability and poor quality of life in these patients.

A Multicenter, Randomized, Double-blind, Non-benzylisoxazole Propionic Acid (BIPA) Controlled Phase II Clinical Study Evaluating the Efficacy and Safety of BR2251 Tablets in Patients With Primary Gout and Hyperuricemia

n=160 · NCT07498647 · NOT_YET_RECRUITING · NOT_YET_RECRUITING

This study is a randomized, double-blind, non-befloxacin-controlled, multicenter, phase II clinical trial, evaluating the efficacy, safety, and pharmacokinetic characteristics of BR2251 tablets when administered multiple times in subjects with primary gout and hyperuricemia. This study is a dose exploration study, including a screening period (up to 2 weeks), a double-blind treatment period (12 weeks), and a follow-up period (2 weeks). The screened subjects were stratified based on whether their serum uric acid (sUA) was less than 480 μmol/L or greater than or equal to 480 μmol/L. They were randomly assigned to 4 treatment groups in a 1:1:1:1 ratio: the test drug group 1 (low-dose group), the test drug group 2 (medium-dose group), the test drug group 3 (high-dose group), and the control group (non-befloxacin tablets 40 mg), with 40 subjects in each group. Each group will use titration dosing.

Gout - Trip Database

TRIP Database

A clinical search engine designed to allow users to quickly and easily find high-quality research evidence to support their practice. It aggregates evidence relevant to gout from multiple sources.

Cochrane reviews on Gout

Cochrane

The Cochrane Library provides a collection of systematic reviews and meta-analyses related to gout, evaluating the effectiveness of various interventions. It is a key resource for evidence-based healthcare decisions.

Gout - TRIP Medical Database

TRIP Database

TRIP Database offers a federated search across multiple sources of evidence, including clinical guidelines, systematic reviews, and primary research on gout. It helps clinicians and researchers find high-quality evidence quickly.