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Management and long-term serum urate control in gout: a population-based primary care cohort study
Maria Antonia Pou1,2,3, Carlen Reyes3,4, Daniel Martinez-Laguna3,5
1Departament de Medicina, Universitat Autònoma de Barcelona, Catalonia, Spain marianpou@gmail.com.
Summary
Long-term serum urate control in gout is poor, with only 12.4% of patients achieving target levels. Optimizing urate-lowering therapy (ULT) initiation, dosage, and adherence is crucial for better gout management.
Area of Science:
- Rheumatology
- Primary Care Medicine
- Epidemiology
Background:
- Gout is a common inflammatory disease with significant cardiovascular risks.
- Current urate-lowering therapies (ULT) are effective but gout management is often suboptimal.
Purpose of the Study:
- To assess clinical characteristics and treatment patterns in gout patients.
- To identify factors influencing long-term serum urate (SU) control.
Main Methods:
- Retrospective cohort study of 94,759 patients diagnosed with gout between 2012-2023.
- Analysis of demographic, clinical, and ULT data from a large primary care database.
- Good SU control defined as SU <6 mg/dL for >=80% of follow-up.
Main Results:
- Only 12.4% of patients achieved good SU control, with no improvement observed over time.
- Common comorbidities include hypertension, dyslipidaemia, diabetes, and chronic kidney disease.
- Factors associated with poor control included delayed ULT initiation, male sex, obesity, and comorbidities.
Conclusions:
- Long-term SU control in gout remains a significant challenge in primary care settings.
- Early ULT initiation, dose optimization, and improved adherence are key modifiable targets.
- Improving gout management requires a focus on these actionable strategies.
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