The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort
OBJECTIVE To characterise adherence and treat-to-target (T2T) strategy in gout patients within a Swiss tertiary hospital. METHODS Consecutive presenting patients with proven gout were prospectively included in this cohort. Symptoms, comorbidities,...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2019-09-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/2664 |
| _version_ | 1811288491511775232 |
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| author | Barbara Ankli Christoph T. Berger Nicolas Haeni Diego Kyburz Thomas Hügle Alexander K.-L. So Thomas Daikeler |
| author_facet | Barbara Ankli Christoph T. Berger Nicolas Haeni Diego Kyburz Thomas Hügle Alexander K.-L. So Thomas Daikeler |
| author_sort | Barbara Ankli |
| collection | DOAJ |
| description |
OBJECTIVE
To characterise adherence and treat-to-target (T2T) strategy in gout patients within a Swiss tertiary hospital.
METHODS
Consecutive presenting patients with proven gout were prospectively included in this cohort. Symptoms, comorbidities, medication and laboratory values were assessed (during hospitalisation and at planned 3- and 12-month follow-up assessments).
RESULTS
116 patients (98 men) with a mean age of 67 (range 23–94 years) were included, 74% of whom had active arthritis. Comorbidities were frequent: hypertension, renal impairment, and obesity were present in 72, 55 and 35% of patients, respectively. Thirty-five percent of patients received urate-lowering treatment at inclusion. Only 62 and 50% attended the 3- and 12-month follow-up. The target serum uric acid level of <360 μmol/l was achieved in 22 and 57% of patients by the 3- and 12-month follow-up visits, respectively. Patients followed up by rheumatologists reached the target serum uric acid at follow-up more often than those that were not (p = 0.033). Median daily allopurinol dose at 12-month follow-up was 300 mg in those achieving T2T and 100 mg in the others (p = 0.033). Flares occurred during the first 3 months in 52% and during the subsequent 9 months in 47% of patients.
CONCLUSION
Only half of patients attended the planned follow-up visits, indicating low awareness for gout. Of those attending follow-up, only approximately 50% had achieved the serum urate target at 12 months. Although new treatments are available, care for gout patients remains insufficient, notably in difficult-to-treat multimorbid patient subsets as described in this cohort.
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| first_indexed | 2024-04-13T03:38:01Z |
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| id | doaj.art-4ed5cdae834242debbedc449ecdf5a9e |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-13T03:38:01Z |
| publishDate | 2019-09-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-4ed5cdae834242debbedc449ecdf5a9e2022-12-22T03:04:15ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972019-09-01149353610.4414/smw.2019.20121The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohortBarbara Ankli0Christoph T. Berger1Nicolas Haeni2Diego Kyburz3Thomas Hügle4Alexander K.-L. So5Thomas Daikeler6Department of Rheumatology, University Hospital Basel, Switzerland; Department of Rheumatology, Schmerzklinik Basel, SwitzerlandMedical Outpatient Clinic, University Hospital Basel, Switzerland; Department of Biomedicine, Translational Immunology Laboratory, University Hospital Basel, SwitzerlandFaculty of Medicine, University of Basel, SwitzerlandDepartment of Rheumatology, University Hospital Basel, SwitzerlandService de Rhumatologie, Département de l'appareil locomoteur, CHUV, Lausanne, SwitzerlandService de Rhumatologie, Département de l'appareil locomoteur, CHUV, Lausanne, SwitzerlandDepartment of Rheumatology, University Hospital Basel, Switzerland OBJECTIVE To characterise adherence and treat-to-target (T2T) strategy in gout patients within a Swiss tertiary hospital. METHODS Consecutive presenting patients with proven gout were prospectively included in this cohort. Symptoms, comorbidities, medication and laboratory values were assessed (during hospitalisation and at planned 3- and 12-month follow-up assessments). RESULTS 116 patients (98 men) with a mean age of 67 (range 23–94 years) were included, 74% of whom had active arthritis. Comorbidities were frequent: hypertension, renal impairment, and obesity were present in 72, 55 and 35% of patients, respectively. Thirty-five percent of patients received urate-lowering treatment at inclusion. Only 62 and 50% attended the 3- and 12-month follow-up. The target serum uric acid level of <360 μmol/l was achieved in 22 and 57% of patients by the 3- and 12-month follow-up visits, respectively. Patients followed up by rheumatologists reached the target serum uric acid at follow-up more often than those that were not (p = 0.033). Median daily allopurinol dose at 12-month follow-up was 300 mg in those achieving T2T and 100 mg in the others (p = 0.033). Flares occurred during the first 3 months in 52% and during the subsequent 9 months in 47% of patients. CONCLUSION Only half of patients attended the planned follow-up visits, indicating low awareness for gout. Of those attending follow-up, only approximately 50% had achieved the serum urate target at 12 months. Although new treatments are available, care for gout patients remains insufficient, notably in difficult-to-treat multimorbid patient subsets as described in this cohort. https://www.smw.ch/index.php/smw/article/view/2664Arthritiscrystalflaregouthyperuricaemia |
| spellingShingle | Barbara Ankli Christoph T. Berger Nicolas Haeni Diego Kyburz Thomas Hügle Alexander K.-L. So Thomas Daikeler The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort Swiss Medical Weekly Arthritis crystal flare gout hyperuricaemia |
| title | The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort |
| title_full | The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort |
| title_fullStr | The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort |
| title_full_unstemmed | The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort |
| title_short | The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort |
| title_sort | target uric acid level in multimorbid patients with gout is difficult to achieve data from a longitudinal swiss single centre cohort |
| topic | Arthritis crystal flare gout hyperuricaemia |
| url | https://www.smw.ch/index.php/smw/article/view/2664 |
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