Hyo Jin Choi1, Chan Hee Lee2, Joo Hyun Lee3, Bo Young Yoon3, Hyoun Ah Kim4, Chang Hee Suh4, Sang Tae Choi5, Jung Soo Song5, Ho Yeon Joo6, Sung Jae Choi7, Ji Soo Lee8, Kee Chul Shin9, Han Joo Baek1. 1. Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea. 2. Division of Rheumatology, Department of Internal Medicine, NHIS Ilsan Hospital, Goyang-si, Korea. 3. Division of Rheumatology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea. 4. Division of Rheumatology, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea. 5. Division of Rheumatology, Department of Internal Medicine, Choong Ang University Hospital, Seoul, Korea. 6. Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea. 7. Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. 8. Division of Rheumatology, Department of Internal Medicine, Ewha Womans University Medical Center, Incehon, Korea. 9. Division of Rheumatology, Department of Internal Medicine, SNU Boramae Medical Center, Seoul, Korea.
Abstract
AIM: To evaluate treatment patterns and clinical factors affecting gout flare in South Korea. METHODS: We retrospectively examined data from 401 patients seen at nine rheumatology multicenter clinics, under urate lowering therapy (ULT) more than 6 months after stopping prophylactic medication. Demographic data, clinical and laboratory features were collected at the initiation of ULT, upon stopping prophylaxis, and 6 months after. RESULTS: The mean age was 52.2 years and mean disease duration was 25.0 months. The male-to-female count was 387 : 14. The most common ULT starting agent was allopurinol 83.8%. Colchicine (62.3%) was the most commonly prescribed prophylactic agent. During ULT, 134 of the 401 patients (33.4%) experienced at least one gouty attack in the period from stopping prophylaxis to 6 months later. The duration of prophylaxis was different between those with serum uric acid levels below 6 mg/dL and those over 6 mg/dL (P = 0.001). Of the 179 patients (44.6%) who attained target serum uric acid (SUA) levels (6 mg/dL) at the end of prophylaxis, those taking < 6 months of prophylaxis suffered more frequent flares than those taking it ≥ 6 months (42.9% vs. 26.3%, P = 0.041). The time interval to the first attack after stopping prophylaxis was shorter in the < 6 months group than the ≥ 6 months group (13.5 weeks vs. 22.5 weeks, P = 0.007). CONCLUSIONS: Prophylaxis more than 6 months from initiation of ULT, and achieving target SUA (< 6 mg/dL) at the time of stopping prophylaxis is associated with fewer gout flares during ULT.
AIM: To evaluate treatment patterns and clinical factors affecting gout flare in South Korea. METHODS: We retrospectively examined data from 401 patients seen at nine rheumatology multicenter clinics, under urate lowering therapy (ULT) more than 6 months after stopping prophylactic medication. Demographic data, clinical and laboratory features were collected at the initiation of ULT, upon stopping prophylaxis, and 6 months after. RESULTS: The mean age was 52.2 years and mean disease duration was 25.0 months. The male-to-female count was 387 : 14. The most common ULT starting agent was allopurinol 83.8%. Colchicine (62.3%) was the most commonly prescribed prophylactic agent. During ULT, 134 of the 401 patients (33.4%) experienced at least one gouty attack in the period from stopping prophylaxis to 6 months later. The duration of prophylaxis was different between those with serum uric acid levels below 6 mg/dL and those over 6 mg/dL (P = 0.001). Of the 179 patients (44.6%) who attained target serum uric acid (SUA) levels (6 mg/dL) at the end of prophylaxis, those taking < 6 months of prophylaxis suffered more frequent flares than those taking it ≥ 6 months (42.9% vs. 26.3%, P = 0.041). The time interval to the first attack after stopping prophylaxis was shorter in the < 6 months group than the ≥ 6 months group (13.5 weeks vs. 22.5 weeks, P = 0.007). CONCLUSIONS: Prophylaxis more than 6 months from initiation of ULT, and achieving target SUA (< 6 mg/dL) at the time of stopping prophylaxis is associated with fewer gout flares during ULT.