Gout: Underwood M

Underwood M. · No affiliation provided · BMJ. · Pubmed #18258933 No free full text.

This publication has no abstract.

Underwood M. · Institute of Community Health Sciences, Barts and London Queen Mary's School of Medicine and Dentistry, University of London, London, UK. · Clin Evid. · Pubmed #16973059 No free full text.

This publication has no abstract.

Underwood M. · Department of General Practice and Primary Care, Centre for Health Sciences, University of London, London E1 2AT.. · BMJ. · Pubmed #16740561 links to  free full text

This publication has no abstract.

Sutaria S, Katbamna R, Underwood M. · Barts and The London, Queen Mary, University of London, Institute of Health Sciences, London, UK. · Rheumatology (Oxford). · Pubmed #16632483 links to  free full text

Abstract: OBJECTIVE: To determine the evidence for the effectiveness of treatments for acute gout and the prevention of recurrent gout. METHOD: Seven electronic databases were searched for randomized controlled trials of treatments for gout from their inception to the end of 2004. No language restrictions were applied. All randomized controlled trials of treatments routinely available for the treatment of gout were included. Trials of the prevention of recurrence were included only if patients who had had gout and had at least 6 months of follow-up were studied. RESULTS: We found 13 randomized controlled trials of treatment for acute gout, two of which were placebo controlled. Colchicine was found to be effective in one study; however, the entire colchicine group developed toxicity. The only robust conclusion from studies of non-steroidal anti-inflammatory drugs is that pain relief from indometacin and etoricoxib are equivalent. We found one randomized controlled trial, reported only as a conference abstract, of recurrent gout prevention. CONCLUSION: The shortage of robust data to inform the management of a common problem such as gout is surprising. All of the drugs used to treat gout can have serious side effects. The incidence of gout is highest in the elderly population. It is in this group, who are at a high risk of serious adverse events, that we are using drugs of known toxicity. The balance of risks and benefits for the drug treatment of gout needs to be reassessed.

Underwood M. · Institute of Community Health Sciences, Barts and the London, Queen Mary's School of Medicine and Dentistry, Queen Mary, University of London, London, UK. · Clin Evid. · Pubmed #16135298 No free full text.

This publication has no abstract.

Underwood M. · Institute of Community Health Sciences Barts and the London, Queen Mary's School of Medicine and Dentistry, Queen Mary, University of London, London, UK. · Clin Evid. · Pubmed #15652066 No free full text.

This publication has no abstract.

Underwood M. · Institute of Community Health Sciences Barts and the London, Queen Mary's School of Medicine and Dentistry, Queen Mary, University of London, London, UK. · Clin Evid. · Pubmed #15555144 No free full text.

This publication has no abstract.

Underwood M. · Warwick Medical School, Coventry, UK. · Clin Evid (Online). · Pubmed #19445790 No free full text.

Abstract: INTRODUCTION: Gout affects about 5% of men and 1% of women, with up to 80% of people experiencing a recurrent attack within 3 years. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for acute gout? What are the effects of treatments to prevent gout in people with prior acute episodes? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2008 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 21 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: colchicine, corticosteroids, corticotrophin (ACTH), non-steroidal anti-inflammatory drugs (NSAIDs), sulfinpyrazone, xanthine oxidase inhibitors, advice to lose weight, advice to reduce alcohol intake, advice to reduce dietary intake of purines.