This is the final installment of a three-part series of case-based articles on optimal, evidence-based approaches to the management of gout, an inflammatory arthritis that over the past two decades has doubled in prevalence in the United States. Here, management approaches are outlined for a patient with a history of hypertension, hypercholesterolemia, and nephrolithiasis. The patient’s first gout attack occurred approximately 10 years ago, but for the past three years the gout attacks have become more frequent.
This activity has been designed to meet the educational needs of nephrologists and other clinicians involved in the treatment of patients with gout.
After completing the activity, the participant should be better able to:
- Describe how renal function affects the management of gout.
- Evaluate current and emerging options for urate-lowering therapy with regard to their benefits and limitations in patients with varying degrees of renal impairment.
- Discuss ways to motivate patient adherence to a long-term treatment plan that incorporates lifestyle considerations and pharmacotherapy.
STATEMENT OF NEED:
Clinicians today face an increasing number of patients with gout. Nephrologists in particular must contend with complex cases in patients with varying degrees and stages of renal dysfunction in addition to other comorbidities and individual characteristics that affect treatment decisions and, ultimately, treatment success. As gout occurs in tandem with renal disorders, nephrologists must be able to appropriately identify and treat these patients.
AMA PRA Category 1 Credit(s)TM
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Medical Education Resources (MER) and Haymarket Medical Education. MER is accredited by the ACCME to provide continuing medical education for physicians.
Medical Education Resources designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Anthony J. Bleyer, MD
Professor of Medicine
Section of Nephrology
Wake Forest University School of Medicine
Disclosure of Conflicts of Interest
Medical Education Resources ensures balance, independence, objectivity, and scientific rigor in all our educational programs. In accordance with this policy, MER identifies conflicts of interest with its instructors, content managers, and other individuals who are in a position to control the content of an activity. Conflicts are resolved by MER to ensure all scientific research referred to, reported, or used in a CME activity conforms to the generally accepted standards of experimental design, data collection, and analysis. MER is committed to providing its learners with high-quality CME activities that promote improvements or quality in health care and not a commercial interest.
The faculty reported the following financial relationships with commercial interests whose products or services may be mentioned in this CME activity:
Anthony J. Bleyer, MD
Consultant: Takeda Pharmaceuticals, Savient Pharmaceuticals
Publishing Staff Disclosures
The content managers, Krista Sierra, Susan Basilico, Jody A. Charnow and Marina Galanakis of Haymarket Medical Education, and Julie Johnson, PharmD, of Medical Education Resources, have disclosed that they have no relevant financial relationships or conflicts of interest relating directly or indirectly to this activity.
Disclosure of Unlabeled Use
This educational activity may contain discussion of approved and/or investigational uses of agents that are not indicated by the FDA. Medical Education Resources, Inc. (MER), and Haymarket Medical Education (HME) do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of MER and HME. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
The content and views presented in this educational activity are those of the authors and do not necessarily reflect those of Savient Pharmaceuticals, Inc., Medical Education Resources or Haymarket Medical Education. The authors have disclosed if there is any discussion of published and/or investigational uses of agents that are not indicated by the FDA in their presentations. The opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of Savient Pharmaceuticals, Inc., Medical Education Resources, or Haymarket Medical Education. Before prescribing any medicine, primary references and full prescribing information should be consulted. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications on dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. The information presented in this activity is not meant to serve as a guideline for patient management.
Medical Education Resources and Haymarket Medical Education jointly sponsor this activity.
If you have any questions relating to the accreditation of this activity, please contact:
Medical Education Resources, Inc.
1500 West Canal Court
Littleton, CO 80120-5615
This activity is supported by an educational grant from Savient Pharmaceuticals.
To obtain credit, a post-test score of 70% or better is required. This CME is offered at no cost to participants. Please proceed with the activity until you have successfully completed this program, answered all test questions, completed the post-test survey, and have received a digital copy of your credit certificate. Your online certificate will be saved on myCME.com within your Profile/Exam History, which you can then access at any time.
WINDOWS PC SYSTEM REQUIREMENTS:
266-MHz Pentium II; Windows 98 or higher; 64 MB RAM; 800 x 600 screen resolution
set for “High Color (16-Bit)”; Macromedia Flash Player 6 or higher.
MACINTOSH® SYSTEM REQUIREMENTS:
Power Mac g3 at 300 MHz; System 8.5 or higher (excluding Mac OSX); 96 MB RAM; 20
MB minimum hard disk space available; 800 x 600 screen resolution set to “Thousands
of Colors”; Macromedia Flash Player 6 or higher.