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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 19h

Okay, only if you bring me a bracelet!

Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 19h

But is this an open invite? 😹

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 21h

Dr. Angelo Gaffo emphasized that gout diagnosis relies on clinical presentation, serum urate, and imaging when available. Crystal confirmation is ideal but not always required. Context and tools matter. #ACR25 #gout #rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 21h

At #ACR25, Dr. Angelo Gaffo emphasized that serum urate can guide gout diagnosis, but timing matters. Levels often decrease during acute flares, underscoring the need for clinical context in interpreting sUA. #Gout #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 21h

Can I have one?!

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

Dr. Tim Kwok emphasized that “difficult-to-treat gout” goes beyond urate levels, involving persistent inflammation, reduced function, and higher healthcare use. A holistic approach addressing clinical, patient, and system factors is key. #2025GCAN #Gout #Rheumatology

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 3d

Tim Kwok @uoftrheum.bsky.social on D2T gout, focusing on equity and who needs to get uricase based therapies

The D2T concept started with RA, has taken hold of axSpA and PsA, and now gout enters the chat

#GCAN2025 #ACR25

EULAR D2T RA 2019
ASAS difficult to manage axSpA 2025
GRAPPA D2T PsA in progress
GCAN D2T gout proposal

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

Throwback 🧢 #GCAN2023

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 3d

BUT CLOAK, a colchicine in knee OA RCT was negative.

Are we asking the wrong Q? Do we need a long duration on colchicine to detect tx benefit?

LoDoCo2 posthoc: colchicine reduced risk of jt replacement

#GCAN2025 #ACR25

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 3d

OA & gout: both related to chronic low level inflammation thru IL-1b

Urate levels have been a/w OA progression & higher synovial fluid IL-1b levels in OA knees

Is there benefit of colchicine in knee OA?

#GCAN2025 #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

Dr. Michael Pillinger: Colchicine continues to show potential CV benefits in gout. Cipolletta et al. found lower short-term MI/stroke risk with colchicine during ULT initiation (HR 0.72). Yokose et al. showed colchicine safer than NSAIDs, though not vs placebo.
#2025GCAN #Gout #Cardiology

Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 3d

⭐Ben Hemming - UAB

More on gout & CVD: recurrent MSU crystal injection induces macrophage protective tolerance. Studied in vivo (mice) and in vitro.

#GCAN2025 #ACR25

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 3d

⭐Daniel Ward Phillips - UAB

Focus on gout & CVD: how does inflammation from MSU crystals cause ASCVD?

Studied in mice: fed a Western diet and injected with MSU crystals

Unique inflam response from EMP1+ macrophage-like monocytes

#GCAN2025 #ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

Dr. Jason Yang: In STOP Gout, achieving SU < 6 mg/dL was linked to flares with lower pain intensity and shorter duration (esp. in pts w/o tophi). Flare characteristics may serve as early indicators of ULT efficacy beyond flare counts.
#2025GCAN #Gout #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

In the STOP Gout trial, 77% of pts achieved SU <6 mg/dL at or below the EasyAllo2-predicted allopurinol dose. Younger age, lower eGFR, and higher SU required higher doses, supporting EasyAllo2 for guided dose escalation.
Dr. Brian Coburn #2025GCAN #Gout #Rheumatology

Rheum Cat @rheumcat.bsky.social · 3d

#GCAN2025 Early Career Investigator abstracts

#ACR25

• Validation of an Allopurinol Dose Prediction Tool to Achieve Goal Serum Urate Among Patients
with Gout in a Protocolized Dose Escalation Trial – Brian Coburn, Philadelphia
•  Characteristics of Gout Flares Over Time with Treat-to-Target Urate-lowering Therapy Use –
Jason Yang, Boston
• Detection of Future Gout Flare Using Peripheral Blood Gene Expression with Machine Learning
– Hussain Aljafer, East Lansing
• The Effect of Prophylactic Colchicine Use on Gene Expression in Gout – Austin Wheeler,
Omaha
• Local MSUc Gout Inflammation Accelerates Atherosclerosis in Ldlr-/- Mice by Expanding an
EMP1+ Monocyte Population Systemically Via DNMT3A And Type-I IFN Signaling – Daniel Ward
Phillips, Birmingham, AL*
*Recipient of the H. Ralph Schumacher Award for highest-ranking Early Career Investigator Abstract
• Macrophage Tolerance Regulates the Progression of Atherosclerosis by MSUc – Ben Hemming,
Birmingham, AL
• Prolonged State of Hyperuricemia Activates the Human Innate Immune System: A Two-year
Follow-up from the GO TEST Finale Study – Brenda Kischkel, Nijmegen

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

Dr. Hyon Choi presents new data supporting treat-to-target urate lowering in gout.
In a 10-year cohort (n=3,613), 95% of flares occurred with SU ≥6 mg/dL and 98% with SU ≥5 mg/dL. Flare rates rose sharply as SU increased, reinforcing the <6 mg/dL goal.
#2025GCAN #Gout #Rheumatology

Rheum Cat @rheumcat.bsky.social · 3d

Dr Hyon Choi (MGH Boston) #GCAN2025 on T2T ULT pragmatic trials in gout

#ACR25

the title slide with yellow text on blue background

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

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Reposted by Thang Le, PharmD, MBA, BCPS, RPh

Rheum Cat @rheumcat.bsky.social · 3d

Dr Hyon Choi (MGH Boston) #GCAN2025 on T2T ULT pragmatic trials in gout

#ACR25

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

AI is advancing crystal disease diagnosis.
Deep learning models can now detect CPPD on hand radiographs, and machine learning of Raman spectra enables point-of-care identification of gout and CPPD.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology #AIinMedicine

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

In a national VA cohort (18,761 CPPD pts, 75,043 controls), nephrolithiasis prevalence was higher in CPPD (8.6% vs 5.1%). Adjusted OR 1.65 supports CPPD as an independent risk factor for kidney stones and a systemic mineralization disorder.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

In >20,000 matched patients aged ≥60, CPPD was linked to a 29% higher risk of any fracture across spine and limb sites over 85,000 patient-years. Risk was consistent in both men and women, supporting bone health screening in CPPD.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

In a Mass General Brigham cohort (1991–2022), 756 CPPD patients had higher 10-year ASCVD risk scores vs matched controls, despite similar CAC burden. Findings suggest factors beyond CAC contribute to elevated CV risk in CPPD.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

From 20-year and 7-year cohort data, chondrocalcinosis was present in 5% at baseline and linked to higher odds of incident knee OA (OR 1.75). No consistent association with knee pain. CC may represent a distinct OA subtype.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

In 51 patients with OA, ultrasound outperformed radiography for detecting CPPD (accuracy 0.78 vs 0.73). Combining both modalities added value only in select cases. US alone was more reliable for CPPD identification.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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Thang Le, PharmD, MBA, BCPS, RPh @teezl.bsky.social · 3d

In a community cohort of 861, knee US detected calcium crystals in 13% of cases, linked to over 50% higher odds of moderate/severe pain and 60% higher odds of radiographic KOA. US-based diagnosis shows promise for broader KOA assessment.
Dr. Geraldine McCarthy #2025GCAN #Rheumatology

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