ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 0245

Impact of Combined Intervention with Clinical Nurse Specialist in the Management of Cardiovascular Risk in Patients with Gout

Claudia Maria Gomez1, Patricio Cardoso Peñafiel1, Jose Antonio Angel-Sesmero1, Marta Novella-Navarro2 and Enrique Calvo-Aranda1, 1Hospital Universitario Infanta Leonor, Madrid, Spain, 2Hospital Universitario La Paz, Madrid, Spain

Meeting: ACR Convergence 2023

Keywords: Cardiovascular, gout, Nursing, Uric Acid, Urate

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, November 12, 2023

Title: (0229–0251) Metabolic & Crystal Arthropathies – Basic & Clinical Science Poster I

Session Type: Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose: Gout is associated with increased cardiovascular risk (CVR). Traditional CVR factors (CVRF) are frequently present in patients with gout, further worsening the prognosis. Several studies have shown that clinical nurse specialist (CNS) contributes effectively to the management of gout. To analyze the detection of CVRF in patients with gout in a rheumatology consultation with CNS and to evaluate short-term changes after a targeted approach.

Methods: Patients with gout according to ACR/EULAR 2015 criteria referred from Primary/Specialized Care due to poor control of the disease. At the first visit, demographic and clinical variables were collected: age, sex, smoking, alcohol, duration of gout, tophi, comorbidities, urate-lowering treatment (ULT) and concomitant drugs. A blood test and review of previous were performed, as well as measurement of blood pressure (BP), weight and abdominal circumference. Nurse-managed calls were made to monitor home measurements and check adherence/tolerance to pharmacological (start/adjustment of ULT, antihypertensive, lipid-lowering and antidiabetic drugs) and non-pharmacological approach (gout education, dietary/lifestyle recommendations) initiated, according to EULAR recommendations for CVR management in rheumatic diseases. We count on multidisciplinary collaboration with other specialists. After 6 months, an in-person visit was made with the same measurements to determine potential changes. A descriptive analysis of the sample was performed. Wilcoxon test was used to evaluate the variation in the parameters studied. The outcome variable was determined as improvement vs no improvement of the dependent variable. χ2 and Mann Whitney U tests were used to evaluate the differences.

Results: Forty patients who met the inclusion criteria were included. Ninety-eight percent were male, with a median age of 66 (58-75) years, severe gout (83% tophaceous, median duration 7 years) and marked presence of CVRF (hypertension 78%, dyslipidemia 55%, smoking 23%, diabetes 23%), some of them previously undetected (10% hypertensive, 3% dyslipidemic, 3% diabetic), and related comorbidities (ischemic heart disease 8%, cerebrovascular disease 5%, chronic kidney disease 20%). Fifty-five percent were not taking ULT and 53% used NSAIDs on a regular basis. At the first visit, ULT was started/adjusted in 95% of patients, antihypertensive in 15%, lipid-lowering drugs in 13%, and anti-diabetes drugs in 8%. At 6 months, there was a significant improvement in sUA and BP, and a non-statistically significant weight reduction (Table). Serum uric acid (sUA) target was achieved in 93% of patients (37/40 < 6 mg/dl, 29/40 < 5 mg/dl). The use of NSAIDs was reduced to 5%. Four out of 9 smokers quit. Systolic BP improved in 73% of patients and diastolic BP in 70%. Dietary and habit modifications, therapeutic adjustments and multidisciplinary care were significantly associated with improved BP (p=0.02).

Conclusion: In patients with difficult-to-treat gout and high CVR, combined intervention with CNS allows substantial short-term changes in CVRF, drastic reduction in NSAID consumption and a high percentage of success in achieving sUA target.

Supporting image 1

Table. Anthropometric, blood pressure and serum uric acid changes 6 months after the first visit. All variables expressed as median/IQR. BP: blood pressure; sUA: serum uric acid


Disclosures: C. Gomez: None; P. Cardoso Peñafiel: None; J. Angel-Sesmero: None; M. Novella-Navarro: Galapagos, 6, Janssen, 5, 6, Lilly, 5, 6, UCB, 5, 6; E. Calvo-Aranda: None.

To cite this abstract in AMA style:

Gomez C, Cardoso Peñafiel P, Angel-Sesmero J, Novella-Navarro M, Calvo-Aranda E. Impact of Combined Intervention with Clinical Nurse Specialist in the Management of Cardiovascular Risk in Patients with Gout [abstract]. Arthritis Rheumatol. 2023; 75 (suppl 9). https://acrabstracts.org/abstract/impact-of-combined-intervention-with-clinical-nurse-specialist-in-the-management-of-cardiovascular-risk-in-patients-with-gout/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to ACR Convergence 2023

ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-combined-intervention-with-clinical-nurse-specialist-in-the-management-of-cardiovascular-risk-in-patients-with-gout/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology