Thursday, 19 Sep 2019

You are here

Adherence to Gout Therapies Painfully Low

There are numerous, highly effective urate-lowering therapies (ULT) to treat and prevent gout attacks, yet gout remains the most common undertreated and poorly treated form of arthritis.  While some of this responsibility lies with healthcare providers, patient factors may color the outcomes.

A retrospective study of the large UK Clinical Practice Research Datalink (1987–2014) sought to assess patient medication compliance in gout and found that adherence to allopurinol in gout is poor, especially among females and younger patients and those with fewer comorbidities. 

They examined newly diagnosed gout patients, ⩾40 years and starting allopurinol (n = 48 280). Non-persistence was measured as amedication gap of ⩾90 days after 1 and 5 years. Non-adherence identified patients whose complied with treatment <80% over the observation period. 

From year 1 to year 5, non-persistence increased from 38.5% to 56.9% after allopurinol initiation. After a first gap in therapy, 43.3% restarted allopurinol therapy within 1 year. Yet again only 52.3% persisted for 1 year.

Non-persistence and non-adherence were higher in females, current smokers.  Persistence and adherence were higher in older and overweight gout patients, those on anti-hypertensives or colchicine and those with comorbidities (dementia, diabetes or dyslipidemia). 

Another metanalysis of 24 studies similarly showed that ULT adherence was less than 48% and  that non-persistence ranged from 54% to 87%. In some of these studies, adherence positively correlated with older age, more comorbidities, and the presence of diabetes or hypertension. (Citation source: http://bit.ly/2wtjN1f)

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Modifiable Risk Factors for Hyperuricemia

Choi and colleagues have shown that four modifiable risk factors (BMI, the DASH diet, alcohol use, and diuretic use) could individually account for a notable proportion of observed hyperuricemia. 

Researchers examine modifiable risk factors for hyperuricemia and how this could be prevented through risk factor modification in the general population.

Opioids Overused in Acute Gout

Opioids were commonly given to patients as a treatment for acute gout attacks, despite the availability of other effective and appropriate therapies, a retrospective study found.

Allopurinol Fails to Curtail Hypertension

Editor's note: July 1 - 5, RheumNow is running the best of the EULAR 2019 meeting. A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Allopurinol Fails to Curtail Hypertension

A novel trial presented at EULAR 2019 last week assessed whether the use of urate-lowering therapy (ULT) would control hypertension in those at risk; however, results of this trial were largely negative.

Hypertension is one of the many comorbidities that plagues gout patients.

Updated 2018 EULAR Recommendations for the Diagnosis of Gout

The first EULAR recommendations for the diagnosis of gout were published in 2006. A task force was formed and following a systematic review, they voted unanimously for changes in all items of the 2006 recommendations.