Time course of changes in the clinical manifestations of gout in men: data of a 7-year retrospective follow-up

• Published in: Terapevtic̆eskii arhiv Vol. 87; no. 5; pp. 10 - 15
• Main Authors: Eliseev, M S, Barskova, V G, Denisov, I S
• Format: Journal Article
• Language: English; Russian
• Published: Russia (Federation) "Consilium Medicum" Publishing house 01-01-2015
• Subjects: Adult; Aged; Allopurinol - administration & dosage; Allopurinol - pharmacology; Arthritis, Gouty - blood; Arthritis, Gouty - drug therapy; Arthritis, Gouty - physiopathology; chronic arthritis; Follow-Up Studies; gout; Gout - blood; Gout - drug therapy; Gout - physiopathology; Gout Suppressants - administration & dosage; Gout Suppressants - pharmacology; Humans; Middle Aged; remission; Remission Induction; Retrospective Studies; Time Factors; uric acid; Uric Acid - blood
• ISSN: 0040-3660; 2309-5342
• DOI: 10.17116/terarkh201587510-15

To estimate the time course of changes in the clinical manifestations of gout and their risk factors during a long-term follow-up.
A total of 160 male patients with gout were examined and followed up for a mean of 6.9 ± 2.0 years. Their clinical assessment included determination of the type of arthritis over time, the frequency of arthritis attacks during one year prior to the examination, the presence and number of subcutaneous tophi, inflamed joints, comorbid or co-occurring diseases (CD), allopurinol adherence, dietary compliance, frequency of taking non-steroidal anti-inflammatory drugs (NSAIDs), diuretics, and alcohol. The serum levels of uric acid (UA), glucose, total cholesterol, and glomerular filtration rate were estimated.
The number of patients taking allopurinol increased from 19% to 64% (p < 0.0001), its average daily dose was 167.6 ± 94.6 mg. The serum level of UA decreased; 16% of the patients achieved its target level. The number of patients with chronic arthritis was not significantly changed. Their serum level of UA was unchanged; the detection rate of subcutaneous tophi and CD rose. During one year, arthritis attacks were absent in 13% of the patients; 90% of them took allopurinol. In these patients, serum UA levels and body mass index significantly declined and the rate of CD was unchanged. None of 18 patients who had their diet and no allopurinol achieved the target level of UA.
Among the gouty patients, 36% refrain from the use of allopurinol, only 23% out of them require that its dose be adjusted to achieve the target level of UA. Dietary compliance is insufficient to reach the target level of UA. Chronic arthritis is associated with the increased incidence of CD.