european crystal network workshop

    Managening gout: treatment of acute attacks, a retrospective study

    Introduction: Gout is a crystal-induced arthropaty, being an extremly painful condition during an acute attack. The right therapeutic solutions can be difficult to find due to multiple co-morbidities of gout.

    Objective: The objective of this study was to evaluate the treatment of patients diagnosed with gout during an acute attack.

    Design: We performed a retrospective, observational study. Participants: Patients diagnosed with gout who were admitted to our Rheumatology Department, during an acutte gout attack.

    Interventions: Patients with unclear diagnosis were excludet. Data was collected from the first patients’medical files.

    Results: We included 231 patients (93%men, 7%women). Mean age was 62.8 years.A chronic state of disease with concomitant active flare was described in 40.69% of patients. Before admission in the hospital 66%of patients with an active flare were on non steroidal anti-inflammatory drugs(NSAIDs), from whitch 19% of them had no benefit regarding the evolution of the goutty attack.During hospitalization pacients recived: 13% colchicine, 52%combination of colchicine and NSAIDs, 33% colchicine, NSAIDs and corticotherapy and 2@ of them were treated only with corticoid. Both oral steroids and local injections were used. The regimen of medication was adapted regarding every patient age, co-morbidities, form of disease (poly/monoarticular), resonse to treatment.The mean duration of the acute flare under treatment was 5 days.From all the patients who were addminted with the diagnostic of chronic gout with an active flare, 92% of them have had alredy been prescribed allopurinol at least 100mg daily. 75% did not achived the serum uric acid level <6 mg/dl.

    Conclusions and Relevance: A chronic disease with concomite active flare was identified in half of the cases. The majority of them were under allopurinol therapy, but faild to achived the target level of serum uric acid. More than half of patients with goutty attack tried to self medicate with NSAIDs.Combination of colchicine and NSAIDs was the elected tratment for most of the patients.Close monitoring the patients during the hospitalization with dosage adjustment as well as patients adherence to treatment and lifestyle is required for achiving good results in to treating gout.

     

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