Pitfalls in management of acute gouty attack, a qualitative research conducted in Makah Region – Saudi Arabia

Peer review under responsibility of Alexandria University Faculty of Medicine.

Available online 17 May 2014

Figures & data

Table 1 Treatment of choice of acute gouty attacks; mono vs. combined therapy, first line of choice and first NSAID of choice.

	Number	%
Choice of mono vs. combined therapy
Mono-therapy	72	72.7
Combined therapy	27	27.3
Total	99	100
First treatment of choice^a
NSAIDs	58	58.6
Oral Colchicine	34	34.3
Allopurinol	18	18.2
Steroid	14	14.1
Uricosuric Agent	7	7.1
IV Colchicine	6	6.1
None	1	1.0
Total	138.00	139.4
First NASID of choice^b
Base	99
Indomethacin	41	41
Profen	21	21
Diclofenac	21	21
Meloxicam (Mobic)	10	10
Celecoxib	6	6
Naproxen	6	6
Piroxicam	2	2
Others	2	2
Total Responses	109	110

Others include; Paracetamol and colchicine.

a Each doctor mentioned an average of 1.39 treatments.

b Each doctor mentioned an average of 1.10 NSAIDs.

Table 2 The use of urate lowering therapy.

	Number	%
Treatments used as a prophylaxis to prevent recurrent attacks^a
Base	95
Allopurinol (ULT)	53	56
Uricosuric agent	22	23
Colchicine	16	17
NSAID	12	13
None	9	9
Other	4	4
Total responses	116	122
When doctors start ULT^b
Base	99
Immediately	29	29
2 weeks later	42	42
4 weeks later	12	12
Other	14	14
Don’t use ULT	2	2
Total responses	99	100
Starting dose of ULT (Allopurinol)^c
Base	99
100 mg	31	31
200 mg	9	9
300 mg	18	18
Depend on the case	41	41
Total responses	99	100
Frequency of using ULT per day
Base	95
Once daily	37	39
Two times daily	16	17
Three times daily	6	6
Depend on the case	33	35
Don’t use ULT	3	3
Total Responses	95	100

a Each doctor mentioned an average of 1.22 treatments. Others include; diet and according to urine uric acid levels.

b Others include; 2 or more severe attacks according to 24 h urine uric acid, according to Uric Acid Level, after 6 months, after stabilization in hospital, after the acute attack subsided, depends on the case, 3 weeks later.

c Each doctor mentioned an average of 1.05 answers.

Table 3 Tests used to follow up.

	Number	%
Base	97
24 h urine uric acid	62	64
Joint X-ray	49	51
Serum creatinine (Renal Functions)	44	45
Urine analysis	36	37
CBC	27	28
Liver function tests	20	21
Ca level	15	15
ECG	3	3
Others	12	12
None of them	6	6
Total responses	274	282

Each doctor mentioned an average of 2.82 tests.

Others include; serum uric acid, joint fluid, ESR and urine.