Achievement of the target serum urate level among patients with gout treated with allopurinol or febuxostat in an arthritis clinic in the Philippines

Abstract

Objective

Gout is an important cause of disability among Filipinos, despite measures for effective management. This study aims to determine attainment of target serum uric acid level (SUA ≤ 6 mg/dl) among patients with gout given urate-lowering therapy (ULT) over 6–12 months.

Methods

This is a single-center, prospective cohort study conducted in one adult Arthritis Clinic at the University of the Philippines-Philippine General Hospital which included 138 patients with gout (1977 ACR criteria), SUA ≥ 6 mg/dl prior to ULT, initiated on ULT (allopurinol or febuxostat), with six months minimum follow-up and with SUA determination post-treatment.

Results

37.7% (52/138) and 36.2% (50/138), achieved target SUA at 6 and 12 months. The factors associated with achieving target SUA in 6 months are BMI > 25 kg/m² [OR 6.98, 95% confidence interval (CI) 1.44–33.88, p value = .016], allopurinol dose ≥ 300 mg (OR 15.76, 95% CI 2.24–111.06, p value = .006), and baseline SUA (OR 0.52, 95% CI 0.33–0.82, p value = .005). The factors associated with achieving target SUA in 12 months are employment (OR 5.51, 95% CI 1.00–30.33, p value = .050), baseline SUA (OR 0.45, 95% CI 0.28–0.74, p value = .002), and age at onset of gout (OR 1.08, 95% CI 1.01–1.15, p value = .026).

Conclusion

Target SUA level was not achieved at 6 and 12 months of ULT in most of this cohort. This mirrors the deficient control of gout and should urge health professionals to fully study and address the problem.

Keywords:

• Allopurinol
• febuxostat
• Filipino
• gouty arthritis

Acknowledgments

The authors highly appreciate their colleagues from the Division of Rheumatology, Department of Internal Medicine, University of the Philippines-Philippine General Hospital: Ainstein Marie Villanueva-Misa, M.D., Gyvenchy Maree Garcia, M.D., Christopher Ryan Pagaduan, M.D., Eliza Mia Dejoras, M.D., Annalyn Urbano, M.D., Patricia Pauleen Remalante, M.D., Alfonso Juan Miranda, M.D for data collection; and Professor Alben P. Sagpang from the College of Teacher Education, University of Mindanao, Philippines for his statistical assistance.

Conflict of interest

None.