 |
|
|
 |
A Survey of Current Evaluation and Treatment of Gout
NAOMI SCHLESINGER, DIRK F. MOORE, JENNIFER D. SUN, and H. RALPH SCHUMACHER Jr ABSTRACT. Objective. To record diagnostic and treatment approaches to gouty arthritis among US rheumatologists. Methods. Questionnaires were faxed to 2500 US rheumatologists. Results. Responses were received from 518 rheumatologists. Respondents reported performing crystal analysis 80% of the time for new suspected gout; 64% use combination therapy for acute gout; nonsteroidal antiinflammatory drugs alone are used in only 27%. Urate-lowering drugs (ULD) are given to most patients. ULD treatment is given occasionally to patients with asymptomatic hyperuricemia (4%) but most frequently to patients after 2 (59%) or 3 (34%) attacks. ULD are given with the aim of achieving a serum urate (SU) level of 6 mg/dl. Conclusion. Combination antiinflammatory agents are used frequently for acute gout despite absence of evidence in the literature to support this practice. There seems to be consensus regarding the necessity of lowering SU to < 6 mg/dl. Approaches vary widely, supporting the need for longterm prospective, placebo controlled studies to provide more evidence-based guidance. (J Rheumatol 2006;33:2050-2) Key Indexing Terms:
GOUT From the Department of Medicine and the Department of Biostatistics, The School of Public Health, University of Medicine and Dentistry of New Jersey (UMDNJ), New Brunswick, New Jersey; and the University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA. N. Schlesinger, MD, Associate Professor of Medicine, Rheumatology Division, Department of Medicine, UMDNJ; D.F. Moore, PhD, Associate Professor; J.D. Sun, MS, Research Assistant, Department of Biostatistics, The School of Public Health, UMDNJ; H.R. Schumacher Jr, MD, Professor of Medicine, Division of Rheumatology, University of Pennsylvania School of Medicine and Director, Arthritis–Immunology Center, Veterans Affairs Medical Center. Address reprint requests to Dr. N. Schlesinger, Clinical Rheumatology, Department of Medicine, UMDNJ–Robert Wood Johnson Medical School, One Robert Wood Johnson Place, PO Box 19, New Brunswick, NJ 08903-0019, USA. E-mail: schlesna@umdnj.edu Accepted for publication May 17, 2006.
|
