Y. Toya, H. Ooyama, M. Senda, Haruka Saimu, Mieko Yokozeki, H. Moromizato, K. Ooyama, H. Uchida, Norifumi Takagi, S. Fujimori
{"title":"Medical Guidance by Nurses for Hyperuricemic and Gouty Patients","authors":"Y. Toya, H. Ooyama, M. Senda, Haruka Saimu, Mieko Yokozeki, H. Moromizato, K. Ooyama, H. Uchida, Norifumi Takagi, S. Fujimori","doi":"10.6032/GNAM.42.189","DOIUrl":"https://doi.org/10.6032/GNAM.42.189","url":null,"abstract":"","PeriodicalId":12746,"journal":{"name":"GOUT AND NUCLEIC ACID METABOLISM","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83113466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Because of accumulation of information on hyperuricemia and gout since 2010, the 3 rd edition of the guideline for the management of hyperuricemia and gout is now going to be processed. After setting the important clinical issues on hyperuricemia and gout, seven clinical questions accompanied by several advantage and disadvantage outcomes have been selected. Using the systematic reviews on reports related to outcome of each clinical question, bias risk of each evidence has been estimated. Taken together with the estimation of body of evidence, the recommendation for the each clinical question will be determined. In addition to clinical questions, review paper regarding the clinical issues of hyperuricemia and gout will be prepared. Thus, this guideline is expected to cover the decision making regarding the important clinical issues on hyperuricemia and gout.
{"title":"Development of Guideline for the management of hyperuricemia and gout in Japan 3rd edition","authors":"I. Hisatome, A. Ohtahara, T. Hamada, K. Ogino","doi":"10.6032/GNAM.42.147","DOIUrl":"https://doi.org/10.6032/GNAM.42.147","url":null,"abstract":"Because of accumulation of information on hyperuricemia and gout since 2010, the 3 rd edition of the guideline for the management of hyperuricemia and gout is now going to be processed. After setting the important clinical issues on hyperuricemia and gout, seven clinical questions accompanied by several advantage and disadvantage outcomes have been selected. Using the systematic reviews on reports related to outcome of each clinical question, bias risk of each evidence has been estimated. Taken together with the estimation of body of evidence, the recommendation for the each clinical question will be determined. In addition to clinical questions, review paper regarding the clinical issues of hyperuricemia and gout will be prepared. Thus, this guideline is expected to cover the decision making regarding the important clinical issues on hyperuricemia and gout.","PeriodicalId":12746,"journal":{"name":"GOUT AND NUCLEIC ACID METABOLISM","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77284964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Oiwa, M. Morita, Misato Kawamichi, K. Fujita, Shin Lee, E. Negoro, Miyuki Ookura, Yasufumi Matsuda, K. Tai, N. Hosono, T. Ueda, T. Yamauchi
Tumor lysis syndrome(TLS)causes hyperuricemia in patients with malignancies under chemotherapeutic treatment. Lowering serum uric acid(S-UA)levels is the most important. Febuxostat has been officially used for chemotherapy-associated hyperuricemia since May 2016 in Japan. Rasburicase and febuxostat reduce S-UA. Rasburicase is effective for high-risk TLS, and febuxostat for low-intermediate risk. Here, febuxostat was evaluated as a treatment for cancer-related hyperuricemia after becoming officially employed for TLS(June 2016 November 2017). Sixty milligram was taken by mouth. The first chemotherapeutic treatment was started within a day after the first 60 mg dosing. The primary endpoint was S-UA normalization(≤ 7 mg /dL)on day 7 of chemotherapy. Twenty-four patients were evaluated(median : 70 years, range : 52-89 years, 14 males /10 females). The baseline S-UA was 7.2±2.7 mg /dL(mean±SD), and S-UA on the 7th day of chemotherapy was 2.5± 1.3 mg /dL(P<0.0001, by paired t-test). All patients met the primary endpoint. In addition, the baseline creatinine was 1.1±0.6 mg /dL(mean±SD), and the value on the 7th day of chemotherapy was 0.8±0.3 mg/dL(P=0.031, by paired t-test). Developing TLS was not observed. Severe adverse reactions were not noted. Thus, 60-mg febuxostat was effective against cancer-associated hyperuricemia. Introduction Tumor lysis syndrome(TLS)occurs in patients with malignancies when the first chemotherapeutic treatment is performed.15) From the cancer cells, purine nucleotides, proteins, phosphorus, and potassium, enter the bloodstream, which results in hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. These conditions may cause renal failure, arrhythmia, and ultimately death. The prevention and the prompt treatment of TLS are crucial. Guidelines and recommendations for the management of TLS have been published.2, 3, 6) There are laboratory and clinical forms of TLS.2, 3, 6) Laboratory TLS is diagnosed when two or more abnormal increases in serum values of uric acid(UA), potassium, or phosphorus are present. Clinical TLS requires, in addition to laboratory TLS, at least one of the followings ; kidney damage, arrhythmias, seizures, or death. The risk of TLS is classified into low受付:2018年2月13日,受理:2018年7月31日 1) Department of Hematology and Oncology 2) Department of Pharmacy, University of Fukui
{"title":"Febuxostat is useful for cancer-associated hyperuricemia in patients with hematologic malignancies","authors":"K. Oiwa, M. Morita, Misato Kawamichi, K. Fujita, Shin Lee, E. Negoro, Miyuki Ookura, Yasufumi Matsuda, K. Tai, N. Hosono, T. Ueda, T. Yamauchi","doi":"10.6032/GNAM.42.157","DOIUrl":"https://doi.org/10.6032/GNAM.42.157","url":null,"abstract":"Tumor lysis syndrome(TLS)causes hyperuricemia in patients with malignancies under chemotherapeutic treatment. Lowering serum uric acid(S-UA)levels is the most important. Febuxostat has been officially used for chemotherapy-associated hyperuricemia since May 2016 in Japan. Rasburicase and febuxostat reduce S-UA. Rasburicase is effective for high-risk TLS, and febuxostat for low-intermediate risk. Here, febuxostat was evaluated as a treatment for cancer-related hyperuricemia after becoming officially employed for TLS(June 2016 November 2017). Sixty milligram was taken by mouth. The first chemotherapeutic treatment was started within a day after the first 60 mg dosing. The primary endpoint was S-UA normalization(≤ 7 mg /dL)on day 7 of chemotherapy. Twenty-four patients were evaluated(median : 70 years, range : 52-89 years, 14 males /10 females). The baseline S-UA was 7.2±2.7 mg /dL(mean±SD), and S-UA on the 7th day of chemotherapy was 2.5± 1.3 mg /dL(P<0.0001, by paired t-test). All patients met the primary endpoint. In addition, the baseline creatinine was 1.1±0.6 mg /dL(mean±SD), and the value on the 7th day of chemotherapy was 0.8±0.3 mg/dL(P=0.031, by paired t-test). Developing TLS was not observed. Severe adverse reactions were not noted. Thus, 60-mg febuxostat was effective against cancer-associated hyperuricemia. Introduction Tumor lysis syndrome(TLS)occurs in patients with malignancies when the first chemotherapeutic treatment is performed.15) From the cancer cells, purine nucleotides, proteins, phosphorus, and potassium, enter the bloodstream, which results in hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia. These conditions may cause renal failure, arrhythmia, and ultimately death. The prevention and the prompt treatment of TLS are crucial. Guidelines and recommendations for the management of TLS have been published.2, 3, 6) There are laboratory and clinical forms of TLS.2, 3, 6) Laboratory TLS is diagnosed when two or more abnormal increases in serum values of uric acid(UA), potassium, or phosphorus are present. Clinical TLS requires, in addition to laboratory TLS, at least one of the followings ; kidney damage, arrhythmias, seizures, or death. The risk of TLS is classified into low受付:2018年2月13日,受理:2018年7月31日 1) Department of Hematology and Oncology 2) Department of Pharmacy, University of Fukui","PeriodicalId":12746,"journal":{"name":"GOUT AND NUCLEIC ACID METABOLISM","volume":"56 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84858814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kuriyama, T. Nakano, Kosuke Honda, Naoki Sugano, Y. Maruyama, O. Miho, T. Hosoya, T. Yokoo
Aim : Evidence has emerged that glycosuria is associated with lowering of serum uric acid （ UA ） levels in patients with diabetes mellitus （ DM ） . The present study investigated whether glycosuria, per se, is involved in the lowering of UA levels in type 2 diabetic patients without hypoglycemic agents with uricosuric property. Subjects & Methods: Individuals who underwent a annual medical check - up and met the inclusion criteria were recruited for this cross - sectional analysis. Diabetic patients being treated with sodium glucose cotransporter 2 （ SGLT2 ） inhibitors were excluded from the analysis. The final participants were a total of 11,649 males, which consisted of euglycemics, prediabetics, and diabetics. Multiple regression analysis was employed to estimate factors in fl uencing serum UA level. Results: The UA level in the overall diabetics （ 5.9 ± 1.4mg/dL, n=704 ） was comparable with that in euglycemics （ 6.0 ± 1.1mg/dL, n=9,871 ） . Prediabetics had the highest UA level among the subgroups （ 6.6 ± 1.3mg/dL, n=1,074 ） . The UA level in diabetics with glycosuria （ 5.5 ± 1.3mg/dL, n=197 ） was lower than that in diabetics without glycosuria （ 6.0 ± 1.2mg/ dL, n=507, p<0.01 ） . In addition, the severity of glycosuria had a negative correlation with the lowering of UA levels in diabetics. In addition, poor diabetic control was associated with the severity of glycosuria. Multiple regression analysis revealed that factors to predict the lowering of UA levels in diabetics were: age, estimated glomerular fi ltration rate （ eGFR ） , and presence of glycosuria. Conclusion: There is a close association between glycosuria and lowering of serum UA levels in patients with DM not being treated with SGLT2 inhibitors. where glucose intolerance becomes apparent, the serum uric acid （ UA ） level increases due to the reduction of UA excretion through the kidney. This occurs in concert with increased insulin resistance and/or hyperinsulinemia, which act on the kidney to increase UA reabsorption, leading to an increase in the circulating serum UA level. A large number of studies have shown that hyperuricemia is closely associated with DM 1 - 7 ） . The prevalence of hyperuricemia was found to be 33% in Type 2 DM patients with central obesity in Asia 8 ） . Hyperuricemia, in addition, is
{"title":"Glycosuria Lowers Serum Uric Acid in Type 2 Diabetics","authors":"S. Kuriyama, T. Nakano, Kosuke Honda, Naoki Sugano, Y. Maruyama, O. Miho, T. Hosoya, T. Yokoo","doi":"10.6032/GNAM.42.173","DOIUrl":"https://doi.org/10.6032/GNAM.42.173","url":null,"abstract":"Aim : Evidence has emerged that glycosuria is associated with lowering of serum uric acid （ UA ） levels in patients with diabetes mellitus （ DM ） . The present study investigated whether glycosuria, per se, is involved in the lowering of UA levels in type 2 diabetic patients without hypoglycemic agents with uricosuric property. Subjects & Methods: Individuals who underwent a annual medical check - up and met the inclusion criteria were recruited for this cross - sectional analysis. Diabetic patients being treated with sodium glucose cotransporter 2 （ SGLT2 ） inhibitors were excluded from the analysis. The final participants were a total of 11,649 males, which consisted of euglycemics, prediabetics, and diabetics. Multiple regression analysis was employed to estimate factors in fl uencing serum UA level. Results: The UA level in the overall diabetics （ 5.9 ± 1.4mg/dL, n=704 ） was comparable with that in euglycemics （ 6.0 ± 1.1mg/dL, n=9,871 ） . Prediabetics had the highest UA level among the subgroups （ 6.6 ± 1.3mg/dL, n=1,074 ） . The UA level in diabetics with glycosuria （ 5.5 ± 1.3mg/dL, n=197 ） was lower than that in diabetics without glycosuria （ 6.0 ± 1.2mg/ dL, n=507, p<0.01 ） . In addition, the severity of glycosuria had a negative correlation with the lowering of UA levels in diabetics. In addition, poor diabetic control was associated with the severity of glycosuria. Multiple regression analysis revealed that factors to predict the lowering of UA levels in diabetics were: age, estimated glomerular fi ltration rate （ eGFR ） , and presence of glycosuria. Conclusion: There is a close association between glycosuria and lowering of serum UA levels in patients with DM not being treated with SGLT2 inhibitors. where glucose intolerance becomes apparent, the serum uric acid （ UA ） level increases due to the reduction of UA excretion through the kidney. This occurs in concert with increased insulin resistance and/or hyperinsulinemia, which act on the kidney to increase UA reabsorption, leading to an increase in the circulating serum UA level. A large number of studies have shown that hyperuricemia is closely associated with DM 1 - 7 ） . The prevalence of hyperuricemia was found to be 33% in Type 2 DM patients with central obesity in Asia 8 ） . Hyperuricemia, in addition, is","PeriodicalId":12746,"journal":{"name":"GOUT AND NUCLEIC ACID METABOLISM","volume":"160 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76625846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Fukuuchi, Madoka Iwasaki, N. Yamaoka, K. Kaneko
{"title":"Study of the changes in the purine content in foods after heat cooking","authors":"T. Fukuuchi, Madoka Iwasaki, N. Yamaoka, K. Kaneko","doi":"10.6032/GNAM.42.165","DOIUrl":"https://doi.org/10.6032/GNAM.42.165","url":null,"abstract":"","PeriodicalId":12746,"journal":{"name":"GOUT AND NUCLEIC ACID METABOLISM","volume":"69 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90755352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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