The Italian Society of Rheumatology clinical practice guidelines for the diagnosis and management of gout
N. Ughi,
I. Prevete,
R. Ramonda,
L. Cavagna,
G. Filippou,
M. Manara,
A. Bortoluzzi,
S. Parisi,
A. Ariani,
C.A. Scirè
Affiliations
N. Ughi
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Division of Clinical Rheumatology, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini CTO ASST Gaetano Pini, Milano
I. Prevete
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Rheumatology Unit, Azienda Ospedaliera San Camillo-Forlanini, Roma
R. Ramonda
Rheumatology Unit, Department of Medicine-DIMED, University Hospital of Padua
L. Cavagna
Department of Rheumatology, University and IRCCS Foundation Policlinico S. Matteo, Pavia
G. Filippou
Department of Medical Sciences, Rheumatology Section, University of Ferrara, Azienda Ospedaliero-Universitaria Sant’Anna di Cona, Ferrara
M. Manara
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Division of Clinical Rheumatology, Centro Specialistico Ortopedico-Traumatologico Gaetano Pini CTO ASST Gaetano Pini, Milano
A. Bortoluzzi
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Department of Medical Sciences, Rheumatology Section, University of Ferrara, Azienda Ospedaliero-Universitaria Sant’Anna di Cona, Ferrara
S. Parisi
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Rheumatology Unit, Azienda Ospedaliera Città della Salute e della Scienza di Torino
A. Ariani
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Department of Medicine, Internal Medicine and Rheumatology Unit, Azienda Ospedaliero-Universitaria di Parma
C.A. Scirè
Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy; Department of Medical Sciences, Rheumatology Section, University of Ferrara, Azienda Ospedaliero-Universitaria Sant’Anna di Cona, Ferrara
Gout is a chronic disease with an increased risk of premature death related to comorbidities. Treatment of gout has proved suboptimal and clinical practice guidelines (CPGs) are expected to have a key role in achieving improvement. Since new evidence has become available, the Italian Society for Rheumatology (SIR) has been prompted to update the 2013 recommendations on the diagnosis and management of gout. The framework of the Guidelines International Network Adaptation Working Group was adopted to identify, appraise (AGREE II), synthesize, and customize the existing gout CPGs to the needs of the Italian healthcare context. The task force consisting of rheumatologists from the SIR Epidemiology Unit and a committee with experience on gout identified key health questions to guide a systematic literature review. The target audience includes physicians and health professionals who manage gout in practice, and the target population includes adult patients suspected or diagnosed as having gout. These recommendations were finally rated by an external multi-disciplinary commission. From a systematic search in databases (Medline, Embase) and grey literature, 8 CPGs were selected and appraised by two independent raters. Combining evidence and statements from these CPGs and clinical expertise, 14 recommendations were developed and graded according to the level of evidence. The statements and potential impact on clinical practice were discussed and assessed. These revised recommendations are intended to provide guidance for the diagnosis and the treatment of gout and to disseminate the best evidence-based healthcare for this disease.
