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Gout should be one of the easiest and best managed of rheumatic disorders. However, numerous deficits exist with regard to the treatment and long-term care of gout.
Swedish investigators have assessed the likelihood of gout patients that would receive and persist with urate lowering therapy.
Using a population-based cohort of 7709 incident gout patients from western Sweden they found that within the first year of their gout diagnosis, 32% received ULT. Higher rates of ULT were seen in males, and those patients with diabetes, cardiovascular and renal disease.
However, a majority (75%) did not persist with ULT treatment within the first 2 years. Age <50 years, lack of comorbidities, and “normal kidney function” or “end-stage kidney failure” were associated with non-persistence with ULT.
Only a minority of patients received ULT and a majority of these did not persist with treatment over the next 2 years. Persistent therapy was more likely in older patients and those with renal impairment and comorbidities.
Although there was no control group or "gold standard" for persistence, it seems obvious that those who need ULT, should remain on ULT.
Gout continues to be undermanaged by those who believe they can manage gout.