Mingshu Sun, Zhaohui Lyu, Can Wang, Yan Li, Dongbao Zhao, Xingwu Ran, Haibing Chen, Benli Su, Xiangyun Chang, Ping Liu, Dewen Yan, Xiuyun Jiang, Kang Chen, Jiaqing Shao, Xiaochun Teng, Yongli Yao, Yuming Li, Ying Chen, Jidong Cheng, Zhifeng Cheng, Zhen Liu, Fengjing Liu, Xinyu Li, Huiyong Yin, Chao Liu, Hsiao-Yi Lin, Yaolong Chen, Wen-Chan Tsai, Ronald M. L. Yip, Changgui Li, Jiajun Zhao
{"title":"2024中国高尿酸血症和痛风诊疗指南更新第1部分：对普通患者的建议","authors":"Mingshu Sun, Zhaohui Lyu, Can Wang, Yan Li, Dongbao Zhao, Xingwu Ran, Haibing Chen, Benli Su, Xiangyun Chang, Ping Liu, Dewen Yan, Xiuyun Jiang, Kang Chen, Jiaqing Shao, Xiaochun Teng, Yongli Yao, Yuming Li, Ying Chen, Jidong Cheng, Zhifeng Cheng, Zhen Liu, Fengjing Liu, Xinyu Li, Huiyong Yin, Chao Liu, Hsiao-Yi Lin, Yaolong Chen, Wen-Chan Tsai, Ronald M. L. Yip, Changgui Li, Jiajun Zhao","doi":"10.1111/1756-185x.70375","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>In 2018, the Chinese Society of Endocrinology developed the “Chinese guideline for diagnosis and treatment of hyperuricemia and gout (2019)”. Over the past 5 years, clinical and experimental research has expanded our knowledge of gout, resulting in novel diagnostic and therapeutic approaches. This update, prompted by new clinical challenges and gaps in evidence, aims to refine the 2019 guidelines.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>The working group formulated clinical questions based on a nationwide questionnaire survey, and the expert panel evaluated new evidence addressing these questions from January 2019 to March 2025. The guideline development followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, adhering to internationally recognized protocols for clinical practice guideline development.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The update includes 26 recommendations addressing 10 clinical questions related to urate-lowering therapy (ULT) for asymptomatic hyperuricemia and reproductive populations, anti-inflammatory treatments, urine alkalinization, dietary advice, and gout diagnosis in patients without a record of hyperuricemia and gout flare predictions in patients with asymptomatic hyperuricemia and intermittent gout. It recommends febuxostat as a first-line ULT for asymptomatic hyperuricemia and using it with caution during pregnancy and lactation. ULT should be customized according to the pathophysiologic type of hyperuricemia. Chronic gout management includes maintaining serum urate levels between 180 and 300 μmol/L and prolonged glucocorticoid tapering in combination with colchicine. Alkalinization with citrate is preferred over sodium bicarbonate for patients with urine pH < 6.0. Novel biomarkers for predicting gout flares are proposed for high-risk populations.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>These updated guidelines incorporate expert consensus and evidence to provide refined strategies for the diagnosis, prevention, and treatment of hyperuricemia and gout.</p>\n </section>\n </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"28 7","pages":""},"PeriodicalIF":2.0000,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70375","citationCount":"0","resultStr":"{\"title\":\"2024 Update of Chinese Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout Part I: Recommendations for General Patients\",\"authors\":\"Mingshu Sun, Zhaohui Lyu, Can Wang, Yan Li, Dongbao Zhao, Xingwu Ran, Haibing Chen, Benli Su, Xiangyun Chang, Ping Liu, Dewen Yan, Xiuyun Jiang, Kang Chen, Jiaqing Shao, Xiaochun Teng, Yongli Yao, Yuming Li, Ying Chen, Jidong Cheng, Zhifeng Cheng, Zhen Liu, Fengjing Liu, Xinyu Li, Huiyong Yin, Chao Liu, Hsiao-Yi Lin, Yaolong Chen, Wen-Chan Tsai, Ronald M. 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2024 Update of Chinese Guidelines for Diagnosis and Treatment of Hyperuricemia and Gout Part I: Recommendations for General Patients
Background
In 2018, the Chinese Society of Endocrinology developed the “Chinese guideline for diagnosis and treatment of hyperuricemia and gout (2019)”. Over the past 5 years, clinical and experimental research has expanded our knowledge of gout, resulting in novel diagnostic and therapeutic approaches. This update, prompted by new clinical challenges and gaps in evidence, aims to refine the 2019 guidelines.
Methods
The working group formulated clinical questions based on a nationwide questionnaire survey, and the expert panel evaluated new evidence addressing these questions from January 2019 to March 2025. The guideline development followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, adhering to internationally recognized protocols for clinical practice guideline development.
Results
The update includes 26 recommendations addressing 10 clinical questions related to urate-lowering therapy (ULT) for asymptomatic hyperuricemia and reproductive populations, anti-inflammatory treatments, urine alkalinization, dietary advice, and gout diagnosis in patients without a record of hyperuricemia and gout flare predictions in patients with asymptomatic hyperuricemia and intermittent gout. It recommends febuxostat as a first-line ULT for asymptomatic hyperuricemia and using it with caution during pregnancy and lactation. ULT should be customized according to the pathophysiologic type of hyperuricemia. Chronic gout management includes maintaining serum urate levels between 180 and 300 μmol/L and prolonged glucocorticoid tapering in combination with colchicine. Alkalinization with citrate is preferred over sodium bicarbonate for patients with urine pH < 6.0. Novel biomarkers for predicting gout flares are proposed for high-risk populations.
Conclusions
These updated guidelines incorporate expert consensus and evidence to provide refined strategies for the diagnosis, prevention, and treatment of hyperuricemia and gout.
期刊介绍：
The International Journal of Rheumatic Diseases (formerly APLAR Journal of Rheumatology) is the official journal of the Asia Pacific League of Associations for Rheumatology. The Journal accepts original articles on clinical or experimental research pertinent to the rheumatic diseases, work on connective tissue diseases and other immune and allergic disorders. The acceptance criteria for all papers are the quality and originality of the research and its significance to our readership. Except where otherwise stated, manuscripts are peer reviewed by two anonymous reviewers and the Editor.
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