2024 Update of Chinese Guidelines for the Management of Hyperuricemia and Gout Part Ⅱ: Recommendations for Patients with Common Comorbidities
10.3760/cma.j.cn311282-20250903-00430
- VernacularTitle:中国高尿酸血症与痛风诊疗指南(2024) 第二部分：常见合并症患者的治疗建议
- Author:
Changgui LI
1
;
Mingshu SUN
;
Zhen LIU
;
Detian LI
;
Changqian WANG
;
Zibin TIAN
;
Yuxiang DAI
;
Zhe FENG
;
Chengfu XU
;
Dongbao ZHAO
;
Feng WEI
;
Bo BAN
;
Chao XIE
;
Zhenmei AN
;
Jia LIU
;
Zhuo LI
;
Yuwei HE
;
Xinde LI
;
Fei YAN
;
Lin HAN
;
Lidan MA
;
Xiaoyu CHENG
;
Tian LIU
;
Xufei LUO
;
Lingling CUI
;
Ying GONG
;
Can WANG
;
Yaolong CHEN
;
Zhaohui LYU
;
Yip Ronald ML
;
Jiajun ZHAO
Author Information
1. 厦门大学附属翔安医院内分泌科，厦门 361100
- Publication Type:Journal Article
- Keywords:
Hyperuricemia;
Gout;
Management;
Comorbidity;
Guideline
- From:
Chinese Journal of Endocrinology and Metabolism
2025;41(11):918-929
- CountryChina
- Language:Chinese
-
Abstract:
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 7 clinical questions for patients with hyperuricemia and gout in the context of comorbidities. Key recommendations include the maintenance of strict serum urate targets, particularly for patients with CKD stage≥3, chronic gouty arthritis, and OA, in order to prevent disease progression. In patients with CVD or diabetes, intra-articular triamcinolone is preferred over systemic glucocorticoids. Prioritized anti-inflammatory treatments for patients with CKD, gastrointestinal diseases and OA are recommended. The guideline also introduces emerging therapies, such as interleukin-1 inhibitors and selective urate transport inhibitors, as potential treatment options for refractory cases. The update offers a comprehensive, patient-centered approach to managing gout, particularly in individuals with associated comorbidities. Multidisciplinary collaboration and emerging new treatments and evidence ensure the optimization of the recommendations.
