Comparative Interpretation of 2015—2020 Chinese and International Guidelines for the Diagnosis and Treatment of Gout

doi:10.12114/j.issn.1007-9572.2021.02.035

Abstract

Abstract: Given the increasing global prevalence of gout，relevant diagnosis and management guidelines issued by gout societies of China and foreign countries will significantly guide the standardized diagnosis and management of gout. In 2015，the American College of Rheumatology and the European League Against Rheumatism jointly released the gout classification criteria，and then the European，American and Chinese gout diagnosis and treatment guidelines have been subsequently updated. We reviewed and compared the 2015—2020 Chinese，European，and US guidelines for the diagnosis and treatment of gout，offering guidance for clinical practice.

Key words: Gout, Guidebook, Diagnosis, Therapy

摘要： 近年来全球痛风发病率呈升高趋势，国内外各学会发布的痛风诊疗指南对其规范化诊治具有指导意义。2015年美国风湿病学会和欧洲抗风湿联盟联合发布了新版痛风分类标准，之后欧洲、美国及中国的痛风诊疗指南均进行了更新。本文从痛风的诊断和治疗两方面对欧洲、美国和中国的痛风诊疗指南进行梳理和对比，以供临床实践参考。

关键词: 痛风, 指南, 诊断, 治疗

ZHANG Da,HUANG Zhifang,LI Xinlun, et al. Comparative Interpretation of 2015—2020 Chinese and International Guidelines for the Diagnosis and Treatment of Gout　[J]. Chinese General Practice, 2021, 24(33): 4196-4199. DOI: 10.12114/j.issn.1007-9572.2021.02.035.
张妲,黄志芳,李新伦等. 2015—2020年国内外痛风诊疗指南比较与解析[J]. 中国全科医学, 2021, 24(33): 4196-4199. DOI: 10.12114/j.issn.1007-9572.2021.02.035.

References

［1］DEHLIN M，JACOBSSON L，RODDY E.Global epidemiology of gout：prevalence，incidence，treatment patterns and risk factors［J］.Nat Rev Rheumatol，2020，16（7）：380-390. DOI：10.1038/s41584-020-0441-1.
［2］LIU R，HAN C，WU D，et al. Prevalence of hyperuricemia and gout in mainland China from 2000 to 2014：a systematic review and meta-analysis［J］.Biomed Res Int，2015，2015：762820. DOI：10.1155/2015/762820.
［3］NEOGI T，JANSEN T L，DALBETH N，et al. 2015 gout classification criteria：an American College of Rheumatology/European League Against Rheumatism collaborative initiative［J］.Ann Rheum Dis，2015，74（10）：1789-1798. DOI：10.1136/annrheumdis-2015-208237.
［4］中华医学会内分泌学分会.中国高尿酸血症与痛风诊疗指南（2019）［J］.中华内分泌代谢杂志，2020，36（1）：1-13. DOI：10.3760/cma.j.issn.1000-6699.2020.01.001.
Chinese Society of Endocrinology.Guideline for the diagnosis and management of hyperuricemia and gout in China（2019）［J］.Chinese Journal of Endocrinology and Metabolism，2020，36（1）：1-13. DOI：10.3760/cma.j.issn.1000-6699.2020.01.001.
［5］徐东，朱小霞，曾学军，等. 痛风诊疗规范［J］.中华内科杂志，2020，59（6）：421-426. DOI：10.3760/cma.j.cn112138-20200327-00306.
XU D，ZHU X X，ZENG X J，et al. Recommendations of diagnosis and treatment of gout in China［J］.Chinese Journal of Internal Medicine，2020，59（6）：421-426. DOI：10.3760/cma.j.cn112138-20200327-00306.
［6］GUTIERREZ M，SCHMIDT W A，THIELE R G，et al. International Consensus for ultrasound lesions in gout：results of Delphi process and web-reliability exercise［J］.Rheumatology：Oxford，2015，54（10）：1797-1805. DOI：10.1093/rheumatology/kev112.
［7］QASEEM A，MCLEAN R M，STARKEY M，et al. Diagnosis of acute gout：a clinical practice guideline from the American College of Physicians［J］.Ann Intern Med，2017，166（1）：52-57. DOI：10.7326/M16-0569.
［8］UGHI N，PREVETE I，RAMONDA R，et al. The Italian Society of Rheumatology clinical practice guidelines for the diagnosis and management of gout［J］.Reumatismo，2019，71（S1）：50-79. DOI：10.4081/reumatismo.2019.1176.
［9］RICHETTE P，DOHERTY M，PASCUAL E，et al. 2018 updated European League Against Rheumatism evidence-based recommendations for the diagnosis of gout［J］.Ann Rheum Dis，2020，79（1）：31-38. DOI：10.1136/annrheumdis-2019-215315.
［10］QASEEM A，HARRIS R P，FORCIEA M A，et al. Management of acute and recurrent gout：a clinical practice guideline from the American College of Physicians［J］.Ann Intern Med，2017，166（1）：58-68. DOI：10.7326/m16-0570.
［11］FITZGERALD J D，DALBETH N，MIKULS T，et al. 2020 American College of Rheumatology guideline for the management of gout［J］.Arthritis Rheumatol，2020，72（6）：879-895. DOI：10.1002/art.41247.
［12］HUI M，CARR A，CAMERON S，et al. The British Society for Rheumatology guideline for the management of gout［J］.Rheumatology：Oxford，2017，56（7）：e1-20. DOI：10.1093/rheumatology/kex156.
［13］RICHETTE P，DOHERTY M，PASCUAL E，et al. 2016 updated EULAR evidence-based recommendations for the management of gout［J］.Ann Rheum Dis，2017，76（1）：29-42. DOI：10.1136/annrheumdis-2016-209707.
［14］DE LAUTOUR H，TAYLOR W J，ADEBAJO A，et al. Development of preliminary remission criteria for gout using Delphi and 1000Minds consensus exercises［J］.Arthritis Care Res（Hoboken），2016，68（5）：667-672. DOI：10.1002/acr.22741.
［15］KILTZ U，SMOLEN J，BARDIN T，et al. Treat-to-target （T2T） recommendations for gout［J］.Ann Rheum Dis，2017，76（4）：632-638. DOI：10.1136/annrheumdis-2016-209467.
［16］PEREZ-RUIZ F，CALABOZO M，PIJOAN J I，et al. Effect of urate-lowering therapy on the velocity of size reduction of tophi in chronic gout［J］.Arthritis Rheum，2002，47（4）：356-360. DOI：10.1002/art.10511.
［17］SUNDY J S，BARAF H S B，YOOD R A，et al. Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment：two randomized controlled trials［J］.JAMA，2011，306（7）：711-720. DOI：10.1001/jama.2011.1169.

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