Treatment in a cohort of patients with gout

Abstract

Introduction. The actuality of the studied subject is conditioned by the increase of the prevalence of gout. Gout arises following the deposition of uric acid crystals in joints as a consequence of hyperuricemia. Frequent co-morbidities, non-compliance of the patients to treatment and the contribution to other organ involvement: cardiovascular diseases, severe nephropathy, disability, all these are major problems that make gout control difficult. The drugs of choice for acute gouty arthritis are nonsteroidal anti-inflammatory drugs (NSAID), colchicine and corticosteroids. Treatment with xanthine oxidase inhibitors or uricosuric drugs is indicated for the long term and the end target is the value of uric acid <360 mcmol/l, and even 300 mcmol/L in patients with advanced tophaceous gout. Aim of the study. Analysis of uric acid lowering therapy, prophylactic treatment of gout flairups and treatment strategy in acute gout attack. Materials and methods. A retrospective study was done on patients diagnosed with gout and hospitalized in the arthrology department of the Republican Clinical Hospital for the year 2018. In the number of 66 patients, 56 of the being males and 10 females, having average age - 58 years. Results. It was found that the average age of the disease debut was 44 years for males and 52 for females. Before hospitalization as the basic treatment 77% of the patients used allopurinol and 23% - febuxostat. 45% of them didn’t administer the treatment on a regular basis, among this group the average level of uric acid was 553 mcmol/l. On the other side, for the group which used to follow to treatment (55%) this indicator was 401 mcmol/l. In the hospital for the acute gout attack in 65% of cases NSAID were used, in 3% - colchicin and the other 29% - combined therapy (NSAID and colchicin). In 53% of cases intraarticular corticosteroids were used. As a basic treatment it was found that for the 83,4% was indicated allopurinol and for the 16,6% febuxostat. Conclusions. I have found correlation between the level of uric acid and compliance with the treatment. Also studied treatment methods of gout depends on the stage of the disease, age of patient, and concomitant diseases.