Adherence to therapy in patients with gout

Despite the availability of effective urate-lowering medicaments, gout is often difficult to correct. Aim of the study - to estimate the adherence to urate-lowering therapy (ULT) in gout patients examined at I.I. Dzhanelidze Saint Petersburg Research Institute of Emergency Medicine. Material and methods. From January to May 2021, a direct survey of 53 patients (49 males and 4 females) suffering from gout, aged 32-85 years (mean age 55,0±8,8 years) was performed. The duration of the disease varied from 1 to 23 years (average 9,1±5,2 years). The participants were asked questions about the age, duration of the disease, the number of gout attacks in the last 12 months, the frequency and last episode of examination by a rheumatologist, adherence to a hypouricemic diet, and the type and kind of receiving pharmacotherapy. 37 patients underwent uric acid level determination (UA). Results. From the 53 examined, only 11,3% of patients had no gout attacks in the last 12 months, in the remaining 88,7% they persisted. Almost half of the patients did not follow the diet at all, 51,0% of the patients did it or tried to comply with periodic deviations. ULT was received by 51,0% of the studied patients. Allopurinol at the time of the survey was taken by 92,6%, most of whom used a dose of 100 mg/day (duration of admission from 2 months to 13 years). Only 3,8% of patients were treated with febuxostat by 80 mg/day dose. 49.0% of patients at the time of the study did not receive ULT. 13,2% from them had previously used allopurinol, but they canceled it on their own. About a third of the participants (30,2%) had never been examined by a rheumatologist before. Only one patient (1,9%) of the interviewed was regularly observed by this specialist. 67,9% of patients consulted a rheumatologist from time to time. At the same time, only 5 patients were examined by a rheumatologist during the last 12 months (13.9% of the group of periodically observed patients). In 69,8% of the respondents, the MC level was determined, and only 3 of them (8,1%) had a target level of this index <6,0 mg/dL. Conclusion. Adherence to therapy among patients with gout is low, in most of the examined the MC level does not reach the target values (91,9%). One of the most important ways to increase adherence to therapy in gout patients is to increase their awareness of the disease and the principles of its treatment.

gout, hyperuricemia, urate-lowering therapy, xanthine oxidase inhibitors, adherence to therapy