Cesar Diaz-Torne (1), Daniel Martinez-Laguna (2), Raquel Gayarre (3), Meritxell Aivar (4), Jordi Hoyo (5), Angeles Conesa (2), Carlen Reyes (6), Cristina Carbonell (7), Jose Luis Estebanez (8), Maria Antonia Pou (3)
Affiliation(s):
1. Hospital de La Santa Creu I Sant Pau,
2. Cap Sant MartÃ,
3. EAP Encants,
4. Cap Sants,
5. Cap Numancia,
6. Idiap Jordi Gol,
7. EAP Via Roma, 8. Cap Vila de Gracia
Objective: To determine the percentage of gout patients receiving uricemia-lowering treatment in a Primary Care (PC) cohort. To determine the percentage of patients who have achieved the urate therapeutic target (<6 mg/dl) related to the treatment they are receiving. Material and methods:Retrospective cross-sectional observational study of individuals at least 15 years old who had a diagnosis of gout recorded in the PC electronical record data and met the EULAR/ ACR 2015 diagnostic criteria in seven urban PC centers. The following variables were collected: 1) Demographic (age and sex); 2) Clinical (date of diagnosis, glomerular filtration rate and uricaemia at the time of diagnosis and the last available and urica-reducing treatment (drug and dose).
Results: The mean age was 64.3±12 years and the mean time of disease evolution was 6.6±3.9 years. One hundred and seventy-two (83.9%) were men. Seven (3.9%) patients had a glomerular filtration rate between 15 and 30 ml/mn/m2 and 61 (33.9%) <60 ml/mn/m2. Mean uric acid at diagnosis was 8.5±1.5mg/dl and at the time of data collection was 6.7±1.8mg/dl. Sixty-two (39.2%) patients achieved levels <6mg/dl, 127 (62%) had poor control and 16 (7.8%) had not registered any uricemia levels. Sixty (29.8%) patients had no uricemia-lowering treatment, eighty (42.2%) received allopurinol 100 mg/day, 6 (3%) allopurinol 150 mg/day, 32 (15.6%) allopurinol 300 mg/day and one patient received 400 mg/day. One patient was on febuxostat 40 mg/day and 17 (8.5%) on febuxostat 80 mg/day. Target (<6mg/dl) urate levels related to the treatment were: alopurinol 100 mg/day: 18/79 (23%), alopurinol 150 mg/day: 3/5 (60%), alopurinol 300 mg/day: 16/31 (52%), alopurinol 400 mg/day: 0/1, febuxostat 40 mg/day: 0/1 and febuxostat 80 mg/day: 13/18 (72%). Treated patients were more likely to achieve the target uricemia than untreated patients (41% vs 22%; p 0.0235)
Conclusions: Serum urate levels control in patients with gout in PC was suboptimal and the use of uremic lowering therapy was insufficient.