Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Adherence to Gout Guidelines in a Rheumatology Clinic.
Conway, Richard, Coughlan, Robert J., Carey, John J.
Gout is a common cause of severe acute and chronic debilitating arthopathy. Current drug treatments can reduce the frequency and severity of acute attacks, and eliminate or reverse long term sequelae of gout. Unfortunately many gout patients are poorly managed. Recently published guidelines have set treatment goals for gout management based on serum uric acid levels. A treat to target strategy in a subspeciality gout clinic has the potential to improve patient management.
The aim of this study was to evaluate adherence to recommended serum uric acid levels in the rheumatology outpatients department of a university teaching hospital.
We performed a retrospective study of all patients with a definitive diagnosis of gout attending our subspeciality gout clinic between 1st January 2010 and 31st December 2010. We evaluated adherence with two recently suggested uric acid thresholds, <5mg/dL and <6mg/dL. Patient management was judged to adhere to the guidelines if either 1) The latest serum uric acid level was less than the specified guideline targets, or 2) Uric acid lowering therapy was titrated upwards or the agent changed if the serum uric acid was above the guideline targets.
102 patients with a definitive diagnosis of gout attended the outpatients department between 1st January 2010 and 31st December 2010 and were included in the study. Median serum uric acid level was 5.57mg/dL (IQR 4.64mg/dL 7.67mg/dL). With respect to uric acid lowering therapy, 86 patients (84%) were treated with allopurinol, 6 patients (6%) were treated with febuxostat (one of whom also received probenecid) and 1 with rasburicase. 9 patients (9%) were receiving no uric acid lowering therapy. In 80 patients (78%) the management adhered to a target guideline of <6mg/dL. In 66 patients (65%) the management adhered to a target guideline of <5mg/dL.
A treat to target approach has the potential to improve patient outcomes in the management of gouty arthritis. Our study shows encouraging results with the majority of patients on appropriate therapy, and reaching recommended targets, but there is room for improvement.
To cite this abstract, please use the following information:
Conway, Richard, Coughlan, Robert J., Carey, John J.; Adherence to Gout Guidelines in a Rheumatology Clinic. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2074