OBJECTIVE: To record diagnostic and treatment approaches to gouty arthritis among US rheumatologists. METHODS: Questionnaires were faxed to 2500 US rheumatologists. RESULTS: Responses were received from 518 rheumatologists. Respondents reported performing crystal analysis 80% of the time for new suspected gout; 64% use combination therapy for acute gout; nonsteroidal antiinflammatory drugs alone are used in only 27%. Urate-lowering drugs (ULD) are given to most patients. ULD treatment is given occasionally to patients with asymptomatic hyperuricemia (4%) but most frequently to patients after 2 (59%) or 3 (34%) attacks. ULD are given with the aim of achieving a serum urate (SU) level of 6 mg/dl. CONCLUSION: Combination antiinflammatory agents are used frequently for acute gout despite absence of evidence in the literature to support this practice. There seems to be consensus regarding the necessity of lowering SU to < 6 mg/dl. Approaches vary widely, supporting the need for longterm prospective, placebo controlled studies to provide more evidence-based guidance.
OBJECTIVE: To record diagnostic and treatment approaches to gouty arthritis among US rheumatologists. METHODS: Questionnaires were faxed to 2500 US rheumatologists. RESULTS: Responses were received from 518 rheumatologists. Respondents reported performing crystal analysis 80% of the time for new suspected gout; 64% use combination therapy for acute gout; nonsteroidal antiinflammatory drugs alone are used in only 27%. Urate-lowering drugs (ULD) are given to most patients. ULD treatment is given occasionally to patients with asymptomatic hyperuricemia (4%) but most frequently to patients after 2 (59%) or 3 (34%) attacks. ULD are given with the aim of achieving a serum urate (SU) level of 6 mg/dl. CONCLUSION: Combination antiinflammatory agents are used frequently for acute gout despite absence of evidence in the literature to support this practice. There seems to be consensus regarding the necessity of lowering SU to < 6 mg/dl. Approaches vary widely, supporting the need for longterm prospective, placebo controlled studies to provide more evidence-based guidance.
Authors: Dinesh Khanna; Puja P Khanna; John D Fitzgerald; Manjit K Singh; Sangmee Bae; Tuhina Neogi; Michael H Pillinger; Joan Merill; Susan Lee; Shraddha Prakash; Marian Kaldas; Maneesh Gogia; Fernando Perez-Ruiz; Will Taylor; Frédéric Lioté; Hyon Choi; Jasvinder A Singh; Nicola Dalbeth; Sanford Kaplan; Vandana Niyyar; Danielle Jones; Steven A Yarows; Blake Roessler; Gail Kerr; Charles King; Gerald Levy; Daniel E Furst; N Lawrence Edwards; Brian Mandell; H Ralph Schumacher; Mark Robbins; Neil Wenger; Robert Terkeltaub Journal: Arthritis Care Res (Hoboken) Date: 2012-10 Impact factor: 4.794
Authors: Naomi Schlesinger; Diane C Radvanski; Tina C Young; Jonathan V McCoy; Robert Eisenstein; Dirk F Moore Journal: Open Rheumatol J Date: 2015-06-12
Authors: Ana Beatriz Vargas-Santos; Geraldo da Rocha Castelar-Pinheiro; Evandro Silva Freire Coutinho; H Ralph Schumacher; Jasvinder A Singh; Naomi Schlesinger Journal: PLoS One Date: 2015-08-14 Impact factor: 3.240