Simple Application and Adherence to Gout Guidelines Enables Disease Control: An Observational Study in French Referral Centres

Abstract

Background: In a context of therapeutic inertia, the French Society of Rheumatology (SFR) published its first recommendations on gout in 2020, which were deliberately simple and concise. The objectives of the study were to determine the profile of patients referred to French gout-expert centres, and to examine the results of their management and the factors leading to those results. Methods: Three hundred patients attending a first visit for gout management in three French referral centres were retrospectively and randomly included in this multicentre observational study. Visits were performed at baseline (M0) and scheduled for month 6 (M6), month 12 (M12), and month 24 (M24). Results: Patients were 81% male and had a mean age 62.2 ± 15.2 years. Management followed French recommendations after the baseline visit in 94.9% of cases. SU levels were below 6.0 mg/dL in 59.4% of patients at M6, 67.9% at M12, and 78.6% at M24, with increasing clinical improvement (i.e., flare decrease) over 2 years of follow-up. At M24, 50% of patients were treated with allopurinol (313 ± 105 mg/d), which exceeded renal restrictions of doses in 61.5% of them, and 48.2% received febuxostat (84 ± 36 mg/d). The need for a sufficient dosage of ULT was the only predictive factor found for successful achievement of SU levels < 6.0 mg/dL at a given visit. Conclusions: Simple application of gout-management guidelines is feasible in clinical practice and is efficient, with a majority of patients achieving SU targets and clinical improvement.

The aftermath of Urate‐Lowering TheRApy in gout (ULTRA) registry: The first prospective observational multicenter cohort of Korean patients with gout

“…Therapeutic inertia is defined as the failure of a healthcare provider to initiate or intensify when therapeutic goals are not reached 5 . There have been several studies that have investigated this subject, 6–8 but there has been no Korean study for the time being. The Urate‐Lowering TheRApy in gout (ULTRA) registry is a recently established cohort that prospectively enrolls Korean patients with gout treated in multiple centers nationwide.…”

Gout, Urate, and Crystal Deposition Disease: Launch of the First Journal Dedicated to a Rapidly Growing Field

“…The molecular pathogenesis of the gout flare and tophus deposition Colchicine is effective in prophylaxis against major cardiovascular events [17] Disentangling the causal relationship(s) between crystal disease and associated comorbidity SGLT2 inhibitors are uricosuric, preventive for incident gout [18], have better outcomes for gout with diabetes, and have renal protective effects Factors driving differences in pathogenesis of crystal disease between men and women Allopurinol/febuxostat reach target in the majority of gout patients and improve outcomes with appropriate dosing [19,20] Risk factors for crystal deposition disease in non-European populations Febuxostat cardiovascular safety comparable to allopurinol [21] The role of epigenomic reprogramming in immune response to crystals HLA-B*5801 and ABCG2 pharmacogenomics…”

14th European Crystal Network (ECN) Workshop—Abstract Proceedings

“…Therapeutics were addressed first with allopurinol and two questions-anti-inflammatory effects of allopurinol and cardiovascular outcomes on one hand, and dialysis for the most severe cases on the other hand. Finally, gout management is not only a matter of drug choice, but also of care delivery in order to reduce clinical or therapeutic inertia [2][3][4]. As an example, nurse-led management has been shown to be an outstanding type of care delivery for gout patients, reaching far better outcomes than general practitioners [5,6].…”