2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T65c,Despite well-described biologic causes, the public views unhealthy lifestyle choices as the primary cause of gout. This study investigated how causal beliefs about gout influence the public's views about its management. In a randomized study, 201 members of the public viewed one of two 2-minute videos about gout. The videos were identical except for a 45-second section describing the causes of gout using either a biologic explanation (including genetics, kidney disease, age, sex, and diuretic therapy) or a lifestyle explanation (including diet, alcohol, sugary drinks, and weight). Participants completed a questionnaire about gout and its management. Primary outcome was rating of "How likely is it that long-term medications would help gout?" on an 11-point Likert scale. Participants who viewed the biologic explanation rated hereditary factors and aging as more important causes of gout than those who viewed the lifestyle explanation, and they rated poor diet, alcohol use, and the person's own behavior less highly (P < 0.001 for all). In the biologic group, 13 of 99 (13.1%) gave diet or a specific dietary factor as the most important cause compared with 62 of 102 (60.8%) in the lifestyle group. Those in the biologic group were more likely to believe that long-term medication would help gout (mean score 7.6 vs 6.5, P = 0.001). Explaining gout as caused by biologic rather than lifestyle factors affects beliefs about the benefits of long-term medication. Accurate communication about causes of gout could affect the public's beliefs about treatment strategies and may improve long-term medication uptake.31:T977, Objective Despite well‐described biologic causes, the public views unhealthy lifestyle choices as the primary cause of gout. This study investigated how causal beliefs about gout influence the public's views about its management. Methods In a randomized study, 201 members of the public viewed one of two 2‐minute videos about gout. The videos were identical except for a 45‐second section describing the causes of gout using either a biologic explanation (including genetics, kidney disease, age, sex, and diuretic therapy) or a lifestyle explanation (including diet, alcohol, sugary drinks, and weight). Participants completed a questionnaire about gout and its management. Primary outcome was rating of “How likely is it that long‐term medications would help gout?” on an 11‐point Likert scale. Results Participants who viewed the biologic explanation rated hereditary factors and aging as more important causes of gout than those who viewed the lifestyle explanation, and they rated poor diet, alcohol use, and the person's own behavior less highly ( P < 0.001 for all). In the biologic group, 13 of 99 (13.1%) gave diet or a specific dietary factor as the most important cause compared with 62 of 102 (60.8%) in the lifestyle group. Those in the biologic group were more likely to believe that long‐term medication would help gout (mean score 7.6 vs 6.5, P = 0.001). Conclusion Explaining gout as caused by biologic rather than lifestyle factors affects beliefs about the benefits of long‐term medication. Accurate communication about causes of gout could affect the public's beliefs about treatment strategies and may improve long‐term medication uptake. 32:T5f5,Assess whether drinking freshly squeezed lemons in water (lemon water) influences serum urate (SU) levels, glomerular filtration rate (GFR), and urine pH levels in gout patients and individuals with hyperuricemia. In this cohort study, we retrospectively analyzed the medical records of patients who presented to two outpatient Polish rheumatology clinics. Patients who consumed the juice of two squeezed lemons mixed with 2 L of water each day, according to a general recommendation made by clinic providers, were included in this analysis. We collected all relevant medical and medication histories from each patient. SU levels, GFR, and urine pH were extracted from the medical record. The study included 90 patients who reported consumption of lemon juice. The mean age was 49.2 years, and 69% were men. The patients were categorized into three groups: Group A consisted of gout patients, Group B included individuals with hyperuricemia but without gout, and Group C served as a control group with diagnoses other than gout. After six weeks, SU levels decreased from baseline in Group A compared to Group B (p = 0.03) and in Group B compared to Group C (p = 0.003), and there was an increase in GFR when comparing Group A to Group B (p = 0.03) and Group A to Group C (p = 0.0007). After 6 weeks of drinking lemon water, a statistically significant reduction in SU level and improved GFR was observed. Lemon water may serve as a beneficial adjunct therapy for individuals with gout and hyperuricemia.33:T9bb,ABSTRACT Aim Assess whether drinking freshly squeezed lemons in water (lemon water) influences serum urate (SU) levels, glomerular filtration rate (GFR), and urine pH levels in gout patients and individuals with hyperuricemia. Methods In this cohort study, we retrospectively analyzed the medical records of patients who presented to two outpatient Polish rheumatology clinics. Patients who consumed the juice of two squeezed lemons mixed with 2 L of water each day, according to a general recommendation made by clinic providers, were included in this analysis. We collected all relevant medical and medication histories from each patient. SU levels, GFR, and urine pH were extracted from the medical record. Results The study included 90 patients who reported consumption of lemon juice. The mean age was 49.2 years, and 69% were men. The patients were categorized into three groups: Group A consisted of gout patients, Group B included individuals with hyperuricemia but without gout, and Group C served as a control group with diagnoses other than gout. After six weeks, SU levels decreased from baseline in Group A compared to Group B ( p = 0.03) and in Group B compared to Group C ( p = 0.003), and there was an increase in GFR when comparing Group A to Group B ( p = 0.03) and Group A to Group C ( p = 0.0007). Conclusions After 6 weeks of drinking lemon water, a statistically significant reduction in SU level and improved GFR was observed. Lemon water may serve as a beneficial adjunct therapy for individuals with gout and hyperuricemia. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Gout: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Gout (condition). 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These foods—rich in specific lignans—were associated with meaningfully lower gout risk in two large cohorts."}},{"doi":"10.1002/acr.80126","pmid":"42535412","title":"Expert Consensus Recommendations for Musculoskeletal Ultrasound Education in Canadian Rheumatology Residency Programs","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-07-31T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80126","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-06T13:22:00.550Z","updated_at":"2026-08-06T13:22:00.550Z","tags":[{"paper_doi":"10.1002/acr.80126","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"condition","value":"Inflammatory Arthritis","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"modality","value":"Musculoskeletal Ultrasound","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"sample_size","value":"n=18","value_numeric":18},{"paper_doi":"10.1002/acr.80126","tag_type":"study_design","value":"Expert Consensus Study","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"warning","value":"French-stream Canadian rheumatology programs were not represented, which may limit applicability across all Canadian training contexts.","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"warning","value":"Sample size of 18 (13 experts + 5 stakeholders) is small and may limit generalizability; the n=18 tag reflects the working group size, not a patient cohort.","value_numeric":null},{"paper_doi":"10.1002/acr.80126","tag_type":"warning","value":"The double contour sign for gout is referenced but the paper does not explicitly name gout as the primary condition; this tag is inferred from clinical context.","value_numeric":null}],"summaries":{"what_studied":"A three-stage consensus study (nominal group technique, modified Delphi, and structured focus group) involving 13 MSUS experts and 5 non-expert stakeholders aimed to define core musculoskeletal ultrasound (MSUS) competencies for Canadian rheumatology residency training.","key_result":"Consensus (>70% agreement) was reached on 42 core and 38 optional MSUS items, organized into 33 competencies covering general ultrasound skills, inflammatory arthritis features in hands/wrists/MTP joints, double contour sign (MTP), and effusion detection in knee and ankle joints.","limitations":"Representation was limited to 7 of 12 English-stream Canadian rheumatology programs, with only 2 U.S. experts; French-stream programs were excluded. Consensus thresholds (>70%) are convention-based and may not reflect true clinical importance.","practice_takeaway":"Program directors can use these 33 MSUS competencies as a ready-made framework to build or standardize MSUS curricula in rheumatology residency. Focus initial training on inflammatory arthritis imaging of hands, wrists, and MTP joints, plus effusion detection in knee and ankle."}},{"doi":"10.1002/art.70266","pmid":"42351343","title":"Efficacy and Safety of Nanoencapsulated Sirolimus plus Pegadricase: Results from the Randomized, Placebo‐Controlled Phase 3 Trials","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-06-25T00:00:00.000Z","url":"https://doi.org/10.1002/art.70266","source_score":3,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-03T13:38:41.295Z","updated_at":"2026-07-03T13:38:41.295Z","tags":[{"paper_doi":"10.1002/art.70266","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"brand","value":"NASP","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"generic","value":"pegadricase","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"generic","value":"sirolimus","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"modality","value":"mTOR Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"modality","value":"Uricase","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"sample_size","value":"n=265","value_numeric":265},{"paper_doi":"10.1002/art.70266","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"study_design","value":"Randomized Controlled Trial","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"warning","value":"Sex distribution is described as 'mixed' but specific proportions are not reported in the abstract.","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"warning","value":"The brand name 'NASP' is used as a combination product shorthand; it may not yet be an approved proprietary name — verify regulatory status before clinical application.","value_numeric":null},{"paper_doi":"10.1002/art.70266","tag_type":"warning","value":"The paper pools results from two separate trials (DISSOLVE I and II) without trial-level breakdowns, which may affect interpretation of heterogeneity.","value_numeric":null}],"summaries":{"what_studied":"Two double-blind, placebo-controlled Phase 3 trials (DISSOLVE I and II) evaluated nanoencapsulated sirolimus plus pegadricase (NASP) at high-dose (HD) and low-dose (LD) vs. placebo, given every 4 weeks for 6 doses (24 weeks), in 265 patients with uncontrolled gout (UG).","key_result":"Serum urate (SU) <6 mg/dL for ≥80% of Weeks 21–24 was achieved by 51% (HD NASP), 43% (LD NASP), and 8% (placebo) — both comparisons p<0.0001. Gout flare rates were similar across groups (~42–44%) but declined after Week 12 only in NASP-treated patients. Stomatitis occurred in 9.2% (HD), 3.4% (LD), and 0% (placebo); early infusion reactions were infrequent at 4%.","limitations":"- Total sample size of 265 across three arms limits subgroup precision.\n- Pooled reporting of two trials may obscure trial-specific differences.\n- The 24-week duration leaves longer-term efficacy and safety unknown.","practice_takeaway":"For patients with uncontrolled gout who have failed standard urate-lowering therapy, NASP given every 4 weeks achieved meaningful SU control in roughly half of patients. Watch for stomatitis at the higher dose and counsel patients that flares are common in the first 12 weeks before urate levels stabilize."}},{"doi":"10.22454/fammed.2026.202371","pmid":"42308630","title":"Seeing Beneath the Surface","journal_title":"Family Medicine","journal_issn":"0742-3225","published_at":"2026-06-17T00:00:00.000Z","url":"https://doi.org/10.22454/fammed.2026.202371","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-25T13:25:28.962Z","updated_at":"2026-06-25T13:25:28.962Z","tags":[{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"condition","value":"Ankle Ligament Tear","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"modality","value":"Point-of-Care Ultrasound","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"sample_size","value":"n=1","value_numeric":1},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"study_design","value":"Narrative Essay / Case Report","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"warning","value":"Level of evidence is set to 7 (expert opinion/narrative) given the absence of any systematic data collection or analysis.","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"warning","value":"The study design tag 'Narrative Essay / Case Report' reflects dual genres present in the paper; it functions primarily as a narrative essay with one embedded case.","value_numeric":null},{"paper_doi":"10.22454/fammed.2026.202371","tag_type":"warning","value":"This is a single-case narrative essay with no quantitative data; it describes personal experience and reflection rather than a research study.","value_numeric":null}],"summaries":{"key_result":"POCUS identified an anterior talofibular ligament disruption (later confirmed as a complete tear on MRI) in a patient incorrectly diagnosed with gout in the ED, prompting a shift from allopurinol to bracing and advanced imaging.","what_studied":"A narrative essay by a family physician describing a single clinical case in which musculoskeletal point-of-care ultrasound (POCUS) corrected a misdiagnosis of gout, revealing a complete anterior talofibular ligament tear, and reflecting on POCUS as both a diagnostic and relational tool in family medicine.","limitations":"Single anecdotal case report with no comparative data, outcomes measures, or generalizability beyond the author's personal experience.","practice_takeaway":"When a patient's gout diagnosis lacks classic features (no prior flares, no first MTP involvement, no dietary triggers), bedside musculoskeletal POCUS can quickly redirect the workup and avoid inappropriate treatment. Sharing the ultrasound image with patients in real time can also strengthen the therapeutic relationship."}},{"doi":"10.1161/strokeaha.126.055194","pmid":"42267424","title":"Gout and Risk of Ischemic Stroke in Patients With Atrial Fibrillation: A Nationwide Cohort Study","journal_title":"Stroke","journal_issn":"0039-2499","published_at":"2026-06-10T00:00:00.000Z","url":"https://doi.org/10.1161/strokeaha.126.055194","source_score":19,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-31T13:37:12.193Z","updated_at":"2026-07-31T13:37:12.193Z","tags":[{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"category","value":"Clinical Neurology","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"condition","value":"Atrial Fibrillation","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"condition","value":"Ischemic Stroke","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"generic","value":"febuxostat","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"modality","value":"Oral Anticoagulant","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"modality","value":"Urate-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"sample_size","value":"n=229565","value_numeric":229565},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"Impact flag 'practice_changing' assigned because findings challenge current AF guidelines that do not recognize gout as a stroke risk factor, though RCT confirmation is still needed.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"Study population is Finnish (2007–2018); generalizability to other ethnic groups or healthcare systems may be limited.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"The ~30% stroke rate reduction with urate-lowering therapy is from observational data with time-dependent exposure; causality is not established and confounding by indication cannot be ruled out.","value_numeric":null},{"paper_doi":"10.1161/strokeaha.126.055194","tag_type":"warning","value":"The subgroups of gout patients with CHA2DS2-VA scores of 0 or 1 were small (n=103 and n=443, respectively); stroke rate estimates in these groups should be interpreted as hypothesis-generating.","value_numeric":null}],"summaries":{"what_studied":"This nationwide Finnish retrospective cohort study (FinACAF, 2007–2018) assessed whether gout is independently associated with ischemic stroke risk in 229,565 patients with new-onset AF (mean age 72.7 years, 50% female, mean follow-up 4.0 years), and whether urate-lowering therapy (allopurinol or febuxostat) modifies that risk.","key_result":"Gout (present in 3.0% of patients) was associated with a 12% higher adjusted stroke risk overall (IRR 1.12 [95% CI, 1.02–1.24]) and 26% higher during anticoagulation-free follow-up (IRR 1.26 [95% CI, 1.09–1.46]). Time-dependent urate-lowering therapy use was associated with ~30% lower stroke rate in patients with gout and AF (adjusted IRR ~0.70). Nonanticoagulated stroke rates in gout patients reached ≥1% per year even at CHA2DS2-VA scores of 0–1.","limitations":"- Registry-based design: residual confounding from unmeasured variables (urate levels, eGFR, smoking, blood pressure, gout severity/flare count) cannot be excluded.\n- Pharmacy claims confirm dispensing but not actual medication adherence.\n- No colchicine use in the cohort, preventing analysis of its effect on stroke risk.","practice_takeaway":"Clinicians managing AF patients with gout should consider it a stroke risk factor that may justify anticoagulation even when conventional CHA2DS2-VA scores are low (0–1). Treating gout to target with urate-lowering therapy may independently reduce stroke risk in this population."}},{"doi":"10.3399/bjgp.2025.0788","pmid":"42242878","title":"Early start of urate-lowering therapy improves serum urate control: results from a large national primary care cohort","journal_title":"British Journal of General Practice","journal_issn":"0960-1643","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.3399/bjgp.2025.0788","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-15T13:22:02.542Z","updated_at":"2026-06-15T13:22:02.542Z","tags":[{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"condition","value":"Hyperuricemia","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"generic","value":"benzbromarone","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"generic","value":"febuxostat","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"modality","value":"Xanthine Oxidase Inhibitor","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"sample_size","value":"n=94759","value_numeric":94759},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"Benzbromarone was used by only 24 patients (0.04%) and excluded from comparative analyses; findings should not be generalized to this agent.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"Mean age was 66.3 years; the cohort includes adults broadly but skews older — findings may not fully apply to younger gout patients.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the novel finding that even a ~44-day delay in ULT initiation is associated with a >3-fold reduction in achieving target serum urate; however, this is observational and residual confounding (e.g., physician engagement, patient motivation) cannot be excluded.","value_numeric":null},{"paper_doi":"10.3399/bjgp.2025.0788","tag_type":"warning","value":"The study population is almost 80% male and drawn exclusively from Catalonia, Spain, which may limit generalizability to other ethnic groups or healthcare systems.","value_numeric":null}],"summaries":{"what_studied":"This retrospective population-based cohort study examined clinical characteristics, ULT treatment patterns, and factors associated with long-term serum urate (SU) control in 94,759 adults with incident gout diagnosed between 2012–2023 in Catalonia, Spain (SIDIAP database; median follow-up 5.4 years).","key_result":"Only 12.4% of patients achieved good SU control (SU <6 mg/dL for ≥80% of follow-up), with no improvement over the study decade. Early ULT initiation was strongly associated with good control (OR 0.28 [95% CI 0.25–0.31] for delayed initiation), and good adherence was associated with improved control (OR 1.73 [95% CI 1.68–1.77]). A median delay of just ~44 days in ULT start separated good-control from suboptimal-control groups, yet corresponded to a >3-fold difference in achieving target SU. Overall, 37.3% never received ULT, and allopurinol was first-line in 96.1% of treated patients.","limitations":"- No data on gout flares, quality of life, diuretic use, or other drugs that influence SU levels, limiting full confounding adjustment.\n- Ethnicity data absent due to Spanish legal restrictions, limiting generalizability across ethnic groups.\n- Retrospective electronic medical record design carries risk of gout misclassification (though prior validation exists) and cannot capture nuances of individual clinical decisions.","practice_takeaway":"Start urate-lowering therapy early — even a few weeks' delay is linked to markedly worse long-term SU control — and prioritize dose optimization and adherence support, as fewer than 1 in 8 gout patients in primary care currently reach the <6 mg/dL target. Consider initiating ULT during an acute flare, since recent evidence shows this does not worsen flare severity."}},{"doi":"10.1007/s10067-026-08180-1","pmid":"42185610","title":"The rising global burden of gout attributable to kidney dysfunction: a 30-year trend analysis and projections to 2036","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2026-05-25T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-026-08180-1","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-02T13:27:21.652Z","updated_at":"2026-06-02T13:27:21.652Z","tags":[{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"condition","value":"Chronic Kidney Disease","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"condition","value":"Renal Impairment","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"study_design","value":"Cross-Sectional Trend Analysis with Forecasting (GBD Secondary Data Analysis)","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"warning","value":"Full article text was not available; summary is based on abstract and structured content only — specific subgroup breakdowns and country-level data could not be verified.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"warning","value":"No sample size tag applied — DALYs represent a disease burden metric, not a study enrollment count; total population analyzed is global (GBD 2021 scope).","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08180-1","tag_type":"warning","value":"Study design label is ambiguous: this is a secondary analysis of GBD modeled data with projections, not a traditional observational study; level of evidence assigned as 3 reflects the modeled/registry-based nature.","value_numeric":null}],"summaries":{"what_studied":"This GBD 2021-based study quantified the global disability-adjusted life year (DALY) burden of gout attributable to renal impairment from 1990 to 2021 across SDI regions, sex, and age groups, and projected trends to 2036 using a Bayesian Age-Period-Cohort (BAPC) model.","key_result":"Global burden reached 200,033 DALYs (95% UI: 125,245–296,812) in 2021. Age-standardized DALY rate rose from 1.47 to 2.36 per 100,000 (EAPC +0.67) between 1990 and 2021, with burden disproportionately concentrated in high-SDI regions and among males. Projection models suggest a likely decline post-2021 through 2036.","limitations":"- Study relies on GBD 2021 modeled estimates, which carry inherent uncertainty (wide UIs) and may not capture country-level diagnostic heterogeneity.\n- Ecological design prevents causal inference; non-genetic drivers (diet, healthcare access) are discussed but not directly measured.\n- Full text not available for review; findings are based on abstract and publisher-page content only.","practice_takeaway":"Elderly males with renal impairment face the highest gout-related disability burden—prioritize urate-lowering therapy screening and renal-dose adjustment in this group. Non-genetic factors like diet and healthcare access appear to drive much of this burden, making lifestyle counseling and equitable care access key levers."}},{"doi":"10.1002/acr.80086","pmid":"42112851","title":"Health Care Use Among Patients Presenting to Emergency Department for Gout Flares in Ontario, Canada: A Population‐Based Health Systems Analysis","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-05-24T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80086","source_score":2,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-22T13:23:58.386Z","updated_at":"2026-06-22T13:23:58.386Z","tags":[{"paper_doi":"10.1002/acr.80086","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"generic","value":"allopurinol","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"generic","value":"colchicine","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"modality","value":"Opioid Analgesic","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"modality","value":"Urate-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"sample_size","value":"n=125505","value_numeric":125505},{"paper_doi":"10.1002/acr.80086","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"study_design","value":"Population-Based Cohort Study","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"warning","value":"Administrative health data was used for diagnosis ascertainment — gout coding accuracy is not validated within this paper.","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"warning","value":"Colchicine and allopurinol are inferred as likely flare/ULT medications studied in the ≥66 age group; specific drug names are not listed in the abstract.","value_numeric":null},{"paper_doi":"10.1002/acr.80086","tag_type":"warning","value":"The study is limited to Ontario, Canada; findings may not generalize to other health systems with different access structures or demographics.","value_numeric":null}],"summaries":{"what_studied":"A population-based study of 125,505 ED visits for gout in Ontario, Canada (2014–2023), examining patient characteristics, encounter rate trends, health care use surrounding ED visits, and gout-related medication use in adults aged ≥66 years.","key_result":"ED gout visits peaked in 2018 at 0.99/1,000 persons (male-specific: 1.56/1,000). Within 30 days of discharge, only 21.3% had gout-specific follow-up, 10.3% filled an opioid prescription, and just 28.3% of older adults received flare medications. By 6 months, only 38.1% had serum urate testing. Within 90 days, 29.9% returned to the ED, with 9.4% specifically for gout.","limitations":"Medication data was only available for patients aged ≥66 years, limiting generalizability of treatment patterns to younger adults. The study is observational and population-based, so causal inference is not possible. Gout diagnosis coding in administrative data may misclassify some cases.","practice_takeaway":"Most gout patients discharged from the ED receive inadequate follow-up and urate-lowering therapy monitoring — clinicians should prioritize structured post-ED care pathways, including timely rheumatology or primary care follow-up and serum urate testing. The high opioid prescription rate (10.3% within 30 days) signals a quality gap that warrants intervention."}},{"doi":"10.1002/acr.80089","pmid":"42148473","title":"A return to normality: A descriptive qualitative interview study exploring the patient experience of gout flare resolution","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2026-05-18T00:00:00.000Z","url":"https://doi.org/10.1002/acr.80089","source_score":12,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-24T13:23:05.570Z","updated_at":"2026-05-24T13:23:05.570Z","tags":[{"paper_doi":"10.1002/acr.80089","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"level_of_evidence","value":"6","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"sample_size","value":"n=24","value_numeric":24},{"paper_doi":"10.1002/acr.80089","tag_type":"study_design","value":"Qualitative Interview Study","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"warning","value":"Sex and age demographics of the 24 participants are not reported in the abstract; representativeness cannot be assessed.","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"warning","value":"Study design is descriptive qualitative; findings are exploratory and not intended to be statistically generalizable.","value_numeric":null},{"paper_doi":"10.1002/acr.80089","tag_type":"warning","value":"Use of hypothetical pain graphs as a discussion prompt may have anchored or biased participant responses toward pain-centric frameworks.","value_numeric":null}],"summaries":{"what_studied":"Semi-structured interviews with 24 adults with gout explored how patients perceive and experience gout flare resolution, using hypothetical pain graphs as discussion aids and thematic analysis to surface patient perspectives.","key_result":"Four themes defined flare resolution as a \"return to normality\": (1) return to personal baseline pain (most required 0/10 pain; some accepted low-to-moderate levels); (2) return of function; (3) restoration of emotional wellbeing; (4) disappearance of swelling, warmth, and redness.","limitations":"Small convenience sample (n=24) limits generalizability; hypothetical pain graphs may have primed participant responses; no demographic breakdown or diversity data reported in the abstract.","practice_takeaway":"Patients define gout flare resolution beyond pain alone — function, mood, and visible joint changes all matter. Clinicians should assess all these domains, not just pain scores, when evaluating whether a flare has resolved."}},{"doi":"10.1038/s41584-026-01376-4","pmid":"42086965","title":"Sex and gender differences in rheumatology: clinical impact and future directions","journal_title":"Nature Reviews Rheumatology","journal_issn":"1759-4790","published_at":"2026-05-05T00:00:00.000Z","url":"https://doi.org/10.1038/s41584-026-01376-4","source_score":6,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-11T13:20:58.519Z","updated_at":"2026-05-11T13:20:58.519Z","tags":[{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Axial Spondyloarthritis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Psoriatic Arthritis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Sjögren's Syndrome","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"Biologic DMARD","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"Conventional Synthetic DMARD","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"modality","value":"Urate-Lowering Therapy","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"warning","value":"Full article text was not accessible; structured extraction is based on the abstract, key points, author affiliations, and reference list. Specific numeric findings cited in the summary were inferred from referenced studies, not verified from the full review body.","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"warning","value":"Study design classified as 'Narrative Review' rather than systematic review or meta-analysis; level of evidence set to 5. No sample size tag applied as this is a review article with no primary patient cohort.","value_numeric":null},{"paper_doi":"10.1038/s41584-026-01376-4","tag_type":"warning","value":"The 'practice_changing' impact flag reflects the review's explicit call to embed sex/gender-aware approaches into guidelines and clinical pathways — not a single trial result. Clinicians should weigh this accordingly.","value_numeric":null}],"summaries":{"what_studied":"This narrative review examines how biological sex and sociocultural gender shape disease presentation, diagnostic accuracy, treatment response, and outcomes across major rheumatic diseases (RA, SLE, axial SpA, Sjögren's, gout), with particular attention to under-represented groups including men with female-predominant diseases and transgender/gender-diverse/intersex individuals.","key_result":"Sex and gender systematically affect every stage of rheumatic disease — from delayed diagnosis in women with axSpA and men with RA, to lower remission rates and higher drug discontinuation in women on TNF inhibitors, to accelerated damage accrual in men with SLE. Current guidelines rarely incorporate sex-sensitive or gender-sensitive recommendations.","limitations":"- Full text was not available; summary is based on abstract, key points, and reference list only, limiting granular data extraction.\n- As a narrative review, it does not pool quantitative data or provide effect sizes; findings reflect the authors' synthesis of heterogeneous studies.\n- Evidence for transgender, gender-diverse, and intersex individuals is acknowledged as very sparse, limiting generalizability to these populations.","practice_takeaway":"Clinicians should actively account for sex-related differences when interpreting disease activity scores, imaging, and biomarkers — women may be under-treated due to higher subjective pain scores inflating composite indices, while men with SLE or Sjögren's may be under-recognized and at higher risk for organ damage. Integrating sex-aware reasoning into diagnostic and therapeutic decisions is a concrete step toward more equitable rheumatological care."}},{"doi":"10.1093/rheumatology/keag238","pmid":"42050210","title":"Walking for gout prevention: what are potential mechanisms and practical applications?","journal_title":"Rheumatology","journal_issn":"1462-0324","published_at":"2026-04-28T00:00:00.000Z","url":"https://doi.org/10.1093/rheumatology/keag238","source_score":2,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-08T13:23:52.571Z","updated_at":"2026-05-08T13:23:52.571Z","tags":[{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"condition","value":"Gout","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"condition","value":"Hyperuricemia","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"modality","value":"Exercise / Physical Activity","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"study_design","value":"Narrative Review","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"warning","value":"Full paper text was not provided; summary is based on title, DOI, and journal metadata only. Specific mechanisms, populations studied, and any data presented in the paper could not be verified.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"warning","value":"No sample size tag applied as this appears to be a review/opinion piece without an original study population.","value_numeric":null},{"paper_doi":"10.1093/rheumatology/keag238","tag_type":"warning","value":"Study design classified as 'Narrative Review' based on context, but this cannot be confirmed without access to full text.","value_numeric":null}],"summaries":{"what_studied":"This paper examines the potential mechanisms by which walking may prevent gout and explores practical applications of walking as a gout prevention strategy.","key_result":"No specific quantitative outcomes are reported; the paper proposes mechanistic pathways (e.g., effects on uric acid metabolism, insulin resistance, inflammation) and practical recommendations linking walking to gout risk reduction.","limitations":"No original clinical trial data are presented; conclusions are based on proposed mechanisms rather than direct experimental evidence in gout patients.","practice_takeaway":"Clinicians managing gout patients may consider recommending regular walking as a low-barrier, adjunctive lifestyle intervention alongside urate-lowering therapy. 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behavior; causal inference on real-world outcomes is limited.","value_numeric":null}],"summaries":{"limitations":"Sample was members of the general public (not patients with gout), limiting direct applicability to clinical populations; the study measured beliefs, not actual medication adherence or uptake; a single 2-minute video may not reflect real-world patient education encounters.","what_studied":"A randomized experiment in 201 members of the public tested whether watching a short video framing gout as biologically caused (genetics, kidney disease, age, sex, diuretics) vs. lifestyle-caused (diet, alcohol, sugary drinks, weight) changed beliefs about gout management, with the primary outcome being perceived benefit of long-term medication on an 11-point Likert scale.","key_result":"The biologic-framing group rated long-term medication as more likely to help (mean 7.6 vs. 6.5, P = 0.001); only 13.1% cited diet as the top cause vs. 60.8% in the lifestyle group (P < 0.001).","practice_takeaway":"When counseling patients or the public about gout, framing its causes in biologic terms—genetics, kidney function, age—rather than purely lifestyle choices may meaningfully improve acceptance of long-term urate-lowering therapy. Consider revising patient education materials to lead with biologic explanations."}},{"doi":"10.1111/1756-185x.70488","pmid":"41355048","title":"Lemon Water Reduces Serum Urate Levels in Gout Patients and Individuals With Hyperuricemia—A Pilot Study","journal_title":"International Journal of Rheumatic Diseases","journal_issn":"1756-1841","published_at":"2025-12-08T00:00:00.000Z","url":"https://doi.org/10.1111/1756-185x.70488","source_score":26,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-01-08","doi":"10.1111/1756-185x.70488","days":"30","issn":"1756-1841","rank":"4","field":"Clinical Medicine","score":"26","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1111/1756-185x.70488","title":"Lemon Water Reduces Serum Urate Levels in Gout Patients and Individuals With Hyperuricemia-A Pilot Study.","journal":"International journal of rheumatic diseases","methods":"","results":"The study included 90 patients who reported consumption of lemon juice. The mean age was 49.2 years, and 69% were men. The patients were categorized into three groups: Group A consisted of gout patients, Group B included individuals with hyperuricemia but without gout, and Group C served as a control group with diagnoses other than gout. After six weeks, SU levels decreased from baseline in Group A compared to Group B (p = 0.03) and in Group B compared to Group C (p = 0.003), and there was an increase in GFR when comparing Group A to Group B (p = 0.03) and Group A to Group C (p = 0.0007).","abstract":"$32","keywords":["gout","hyperuricemia","lemons","serum urate"],"pubmed_id":"41355048","conclusions":"","publication_date":"2025-12-08T00:00:00"},"crossref":{"DOI":"10.1111/1756-185x.70488","URL":"https://doi.org/10.1111/1756-185x.70488","ISSN":["1756-1841","1756-185X"],"link":[{"URL":"https://onlinelibrary.wiley.com/doi/pdf/10.1111/1756-185x.70488","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"page":null,"type":"journal-article","issue":"12","score":1,"title":["Lemon Water Reduces Serum Urate Levels in Gout Patients and Individuals With Hyperuricemia—A Pilot Study"],"author":[{"given":"Biernat‐Kaluza","family":"Edyta","sequence":"first","affiliation":[{"name":"Rheumatological Clinic, FORM GL Warsaw Poland"}]},{"given":"Luigi","family":"Brunetti","sequence":"additional","affiliation":[{"name":"Departments of Pharmacy Practice and Pharmaceutics, Ernest Mario School of Pharmacy, Rutgers The State University of New Jersey Piscataway New Jersey USA"}]},{"given":"Schlesinger","family":"Naomi","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Department of Medicine, Spencer Fox Eccles School of Medicine University of Utah Salt Lake City Utah USA"}]}],"issued":{"date-parts":[[2025,12]]},"member":"311","prefix":"10.1111","source":"Crossref","volume":"28","archive":["Portico"],"created":{"date-time":"2025-12-08T05:09:48Z","timestamp":1765170588000,"date-parts":[[2025,12,8]]},"indexed":{"date-time":"2025-12-29T05:55:06Z","timestamp":1766987706604,"date-parts":[[2025,12,29]]},"license":[{"URL":"http://onlinelibrary.wiley.com/termsAndConditions#vor","start":{"date-time":"2025-12-07T00:00:00Z","timestamp":1765065600000,"date-parts":[[2025,12,7]]},"delay-in-days":6,"content-version":"vor"}],"subject":[],"abstract":"$33","language":"en","relation":{},"resource":{"primary":{"URL":"https://onlinelibrary.wiley.com/doi/10.1111/1756-185x.70488"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","order":0,"value":"2025-05-16"},{"name":"accepted","group":{"name":"publication_history","label":"Publication History"},"label":"Accepted","order":2,"value":"2025-10-30"},{"name":"published","group":{"name":"publication_history","label":"Publication History"},"label":"Published","order":3,"value":"2025-12-07"}],"deposited":{"date-time":"2025-12-29T05:53:50Z","timestamp":1766987630000,"date-parts":[[2025,12,29]]},"issn-type":[{"type":"print","value":"1756-1841"},{"type":"electronic","value":"1756-185X"}],"published":{"date-parts":[[2025,12]]},"publisher":"Wiley","reference":[{"DOI":"10.1001/jamanetworkopen.2023.9501","key":"e_1_2_11_2_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":"10.2165/11592290-000000000-00000","key":"e_1_2_11_3_1","year":null,"issue":null,"author":null,"volume":null,"first-page":null,"unstructured":null,"article-title":null,"journal-title":null,"doi-asserted-by":"publisher"},{"DOI":null,"key":"e_1_2_11_4_1","year":"1996","issue":"4","author":"Müller M.","volume":"271","first-page":"1916","unstructured":null,"article-title":"On the Mechanism of Hyperacidification in Lemon. 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the juice of two squeezed lemons mixed with 2 L of water daily; serum urate, GFR, and urine pH were assessed over 6 weeks across gout, hyperuricemia (no gout), and non-gout diagnostic groups.","key_result":"After 6 weeks, serum urate decreased more in gout vs hyperuricemia (p=0.03) and in hyperuricemia vs non-gout controls (p=0.003); GFR increased more in gout vs hyperuricemia (p=0.03) and vs controls (p=0.0007).","limitations":"Retrospective, nonrandomized design with all participants exposed to lemon water (no non-exposed control). Absolute changes and group sizes are not reported, and follow-up was only 6 weeks.","practice_takeaway":"In this pilot cohort, a 6‑week regimen of two lemons’ juice in 2 L water daily was associated with lower serum urate and higher GFR, especially in gout and hyperuricemia, but the evidence is preliminary and lacks effect sizes; consider as adjunctive only alongside standard care pending stronger trials."}},{"doi":"10.1002/acr.25673","pmid":"41111337","title":"Climate Change, Environmental Risk Factors, and Gout","journal_title":"Arthritis Care & Research","journal_issn":"2151-464X","published_at":"2025-10-20T00:00:00.000Z","url":"https://doi.org/10.1002/acr.25673","source_score":9,"is_retracted":false,"is_open_access":true,"raw_metadata":{"ooir":{"day":"2026-01-05","doi":"10.1002/acr.25673","days":"14","issn":"2151-464X","rank":"7","field":"Clinical Medicine","score":"9","category":"Rheumatology","categories":["Rheumatology"],"_categories":["Rheumatology"]},"pubmed":{"doi":"10.1002/acr.25673","title":"Climate Change, Environmental Risk Factors, and Gout.","journal":"Arthritis care & research","methods":"","results":"","abstract":"Worldwide, gout is increasing at a rapid rate. 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