Treat-to-target (T2T) of serum urate (SUA) in gout: a clinical audit in real-world gout patients

  • C.L. Teh | tehchenglay@yahoo.com Rheumatology Unit, Department of Medicine, Sarawak General Hospital, Sarawak, Malaysia.
  • Y.K. Cheong Rheumatology Unit, Department of Medicine, Sarawak General Hospital, Sarawak, Malaysia.
  • S.A. Wan Rheumatology Unit, Department of Medicine, Sarawak General Hospital, Sarawak, Malaysia.
  • G.R. Ling Rheumatology Unit, Department of Medicine, Sibu Hospital, Sarawak, Malaysia.

Abstract

Treat-to-target (T2T) for gout has been established recently to improve its management, which has been reported to be sub-optimal with significant gaps between the goals of treatment and day-to-day clinical practice. T2T recommended a goal of serum urate (SUA) target of <360 μmoI/L in all patients with gout and <300 μmoI/L in patients with tophaceous or severe gout. T2T strategy was applied in the management of gout patients in two Rheumatology clinics from 1 January 2016 onwards. We performed a clinical audit to assess T2T of SUA in gout patients and to identify causes for failure to achieve target SUA among them. There were a total of 304 patients for our analysis. They were of multi-ethnic origin with male predominance (88.8%). They had a mean age of 57.7+13.7 years and mean disease duration of 10.1+8.7 years. The most common comorbidities were hypertension (76.2%), dyslipidemia (52.5%) and diabetes mellitus (DM) (27.4%). Our patients’ body mass indexes showed that 47.7% were obese while 34.2% were overweight. Up to 62.4% of our patients had tophi and 42.6% had joint deformities. Only 34.9% of patients achieved target SUA. Nonadherence (52.3%) was the main reason identified for failure to achieve target SUA. The independent predictors for failure to achieve target SUA were nonadherence (HR=7.84, p=0.000) and presence of tophi (HR=1.95, p=0.001).

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Published
2019-10-24
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Keywords:
Treat to target (T2T), gout.
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How to Cite
Teh, C., Cheong, Y., Wan, S., & Ling, G. (2019). Treat-to-target (T2T) of serum urate (SUA) in gout: a clinical audit in real-world gout patients. Reumatismo, 71(3), 154-159. https://doi.org/10.4081/reumatismo.2019.1225