Improvement in OMERACT domains and renal function with regular treatment for gout: a 12-month follow-up cohort study

• Published in: Clinical rheumatology Vol. 37; no. 7; pp. 1885 - 1894
• Main Authors: Vazquez-Mellado, Janitzia, Peláez-Ballestas, Ingris, Burgos-Vargas, Rubén, Alvarez-Hernández, Everardo, García-Méndez, Sergio, Pascual-Ramos, Virginia, Rull-Gabayet, Marina
• Format: Journal Article
• Language: English
• Published: London Springer London 01-07-2018; Springer Nature B.V
• Subjects: Adult; Allopurinol; Allopurinol - administration & dosage; Cohort analysis; Female; Follow-Up Studies; Gout; Gout - blood; Gout - drug therapy; Gout - physiopathology; Gout Suppressants - administration & dosage; Humans; Kidney - drug effects; Kidney - physiopathology; Male; Medicine; Medicine & Public Health; Metabolic syndrome; Mexico; Middle Aged; Original Article; Pain; Patients; Renal function; Rheumatism; Rheumatology; Time Factors; Treatment Outcome; Uric acid; Uric Acid - blood; Uric acid; Gout treatment; Metabolic syndrome; Gout; Urate
• ISSN: 0770-3198; 1434-9949
• DOI: 10.1007/s10067-018-4065-7

OMERACT proposed a set of mandatory and discretionary domains to evaluate the effect of treatment in patients with gout. To determine the percentage of improvement and the effect size 6 and 12 months after starting a proper treatment in patients with gout from our cohort (GRESGO) based on the OMERACT proposal for chronic gout. GRESGO is a cohort of consecutive, new patients with gout attending either of two dedicated clinics. This report includes 141 patients evaluated at baseline and 6 months plus 101 of them completing a 12-month follow-up in 2012. Clinical data including the OMERACT domains for chronic gout were collected at baseline and every 6 months. Treatment was prescribed by their attending physician with the purpose of getting < 6 mg/dL of seric uric acid (sUA). Most patients were males (96%) with inappropriate treatment (95%); 66% had tophi, 30% metabolic syndrome, and 32% low renal function. Mean dose of allopurinol at baseline and throughout the study went from 344 ± 168 mg/day to 453 ± 198 at 12 months. Most OMERACT domains and renal function improved significantly; 73% improved > 20% from 6 to 12 months. Greater improvement was observed in the domains: flares, index tophus size, pain, general health assessment, and HAQ score, all of them associated to lower sUA values. Chronic gout patients improve significantly in most OMERACT domains when conventional and regular treatment is indicated. sUA < 6 mg/dL is associated with greater improvement.