Outcome of Treatment in Gouty Arthritis Patients: A Retrospective Study
Punchong Hanvivadhanakul MD*, Ratchapruk Wongdet MD*
Affiliation : * Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand
Background : Effective treatment in gouty arthritis can prevent joint and renal damage. Target serum uric acid levels of <6
mg/dl and <5 mg/dl are recommended in gouty arthritis and those with tophi, respectively.
Objective : To evaluate: (i) whether patients achieved recommended serum uric acid target and assess influencing factors and
(ii) renal function between patients who achieved and not achieved the goal.
Material and Method: The medical records of gouty arthritis patients treated in outpatient department at Thammasat
University Hospital between January 2013 and December 2013 were reviewed. Patients were divided into adequately (ATG)
and inadequately treated groups (ITG) based on the ACR uric acid criteria after six months of treatment. Factors associated
with inadequate treatment were explored and post treatment renal function compared between A and ITGs.
Results : Of 139 patients, 46 (33%) achieved target serum uric acid concentrations. Alcoholic consumption was the significant
factor influencing the outcome. 75.5% of patients were followed-up >1 month for second evaluation of uric acid and most of
them not receiving dosage up-titration even though not achieving the target. Both groups had similar alterations of renal
function after treatment (p = 0.68).
Conclusion : Most patients failed to achieve recommended uric acid targets. Alcohol consumption was identified as a key risk
factor for a suboptimal outcome. The treat-to-target approach should be underlined. Other risk factors should be explored
prospectively.
Keywords : Gout, Outcome, Treatment, Serum uric acid level
