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Managing Gout in Primary Care


This handbook discusses developments and the future of gout treatment, which looks promising. ?Gout has been a well-known disease for over 2000 years, and is the most common cause of joint inflammation in adult males. It has become apparent that no therapeutic target based on hyperuricemia outcome had been defined. Very few controlled trials were available to test the efficacy and safety of treatments, and no research on diagnosis and management had been done despite data showing that patients with gout were generally improperly treated even in the hands of specialists. In the last 10 years, good-quality evidence on gout impact and management has grown exponentially, renal transporters have been recently identified, and a number of new drugs have been approved or are under current development.

Fernando Perez-Ruiz (MD, PhD) gained his MD qualification in The Basque Country University in 1985. After passing the Fellowship National Examination Trial, he applied for fellowship at Hospital Ramon y Cajal in Madrid, and joined the Rheumatology Board in 1991. He is a Senior Specialist in the Rheumatology Division at Cruces University Hospital, Baracaldo, Vizcaya, Spain, where he has worked from 1991 to date as a general rheumatologist. Although initially involved with clinical investigation and publications in lupus, rheumatoid arthritis, and fibromyalgia, in the last 20 years he has focused in, and is devoted to, crystal-induced arthritis, and especially gout. He gained his PhD qualification in Barcelona University through studies of classification and urate-lowering therapy in gout. He has presented over 200 scientific communications, over 50 lectures, and published over 100 papers and book chapters, most of them involving clinical investigation in gout or pyrophosphate arthritis. Currently he is also heading the crystal-induced investigation group at the BioCruces Health Investigation Institute. He is an active member of the Spanish Society for Rheumatology (Chair of the Spanish Group for Investigation of Crystal-Induced Arthritis since 2008) and an International Member of the American College of Rheumatology. He collaborates as Associated Editor of Rheumatology International and is a member of the Editorial Committee of Bone Joint Spine, Arthritis, Seminarios de la Fundación Española de Reumatología, and Reumatología Clínica, and formerly of Arthritis Care and Research. He is also an invited reviewer for over thirty international journals. He has collaborated with the European League Against Rheumatism (EULAR) Task Force for gout, EULAR group for pyrophosphate arthritis, the Outcome Measures in Rheumatology (OMERACT) group for gout, the American College of Rheumatology (ACR) Guidelines for Gout, and has also coordinated the Spanish Guidelines for gout management.

Ana María Herrero-Beites (MD) gained her MD qualification in The Basque Country University in 1985. After passing the Fellowship National Examination Trial, she followed a fellowship program at Hospital Ramon y Cajal in Madrid from 1988, and joined the Physical Medicine Board in 1992. She is a Specialist in the Physical Medicine Division at Hospital de Górliz, Vizcaya, Spain, where she has worked from 1992 to date, initially in neurologic rehabilitation and later in musculoskeletal rehabilitation. She leads and coordinates the joint prosthesis rehabilitation process. She has closely collaborated in clinical investigation with Cruces University Hospital and is a member of the crystal-induced arthritis investigation group at BioCruces Health Institute. She has co-authored 12 papers and book chapters on musculoskeletal involvement in gout.