In recent times, increasing interest has been raised on crystal-induced arthritis, especially regarding gout and the development of new medications to treat hyperuricaemia and inflammation, what has been nicely demonstrated by bibliometric studies. Nevertheless, pyrophosphate arthritis (PPA) remains as the “orphan crystal disease”. Risk factors for developing PPA have been recently published.
In the last year, new mechanistic definitions for hyperurcaemia and gout have been proposed Genomics have shown different polymorphisms of renal and intestinal transporters to be associated with increased risk of hyperuricaemia and gout, the metabolic origin of hyperuricemia (overproduction) seeming to be marginal nowadays. In addition, the impact of environmental factors, such as diet and medications has been also investigated.
Imaging is emerging as a useful tool to evaluate the presence of urate deposits and the burden of disease, and the clinical applicability of each of the new imaging techniques, especially ultrasonography and dual energy computed tomography, coming more close to focus.
The importance of inadequate or absence of treatment on the appearance of flares during in-hospital admissions has been recently highlighted. To this point, a proof-of-concept educational intervention on patients, by Rees and coworkers at Nottingham University, has shown to be extremely productive regarding to achievement of therapeutic goals.
A bunch of new medications targeting hyperuricemia of gout are in the pipeline, and some results became available recently. Others, but restricted to a patient-profiled indications such as pegloticase and canakinumab, have been approved by EMA in the last year, others currently used with either empiric or off-label indications.
Disclosure of Interest F. Perez-Ruiz Grant/Research support from: Ministerio de Sanidad, Gobierno de España, Asociacion de Reumatόlogos de CRuces, Consultant for: Astra-Zeneca, Menarini, Metabolex, Novartis, Pfizer, SOBI, Conflict with: Menarini, Astra-Zeneca