Diversity of opinions on the management of gout in France. A survey of 750 rheumatologists.
Gout is a common disease. Although effective treatments are available for gout, there is some disagreement as to how they should be used. To study prescription patterns in gout, we conducted a questionnaire survey among 2520 rheumatologists. Seven hundred and fifty completed questionnaires were returned over a two-month period. Among respondents, 35.4% worked in a private office, 21% in a hospital and 43.6% in both. The most widely prescribed treatments in acute gout attack were colchicine alone (63%), colchicine with a nonsteroidal antiinflammatory drug (NSAID) (31.7%) and NSAID alone (5.2%), with significant variations according to the type of practice. Mean duration of treatment in acute gout was 18 +/- 16.8 days (range, 3-180 days). Mean time interval between the attack and initiation of therapy with a xanthine oxidase inhibitor was 21.6 +/- 17.2 days (range 0-180); here also, significant variations were seen according to the type of practice. Concomitant symptomatic therapy was prescribed in 97.3% of cases, for a mean duration of 54 +/- 55.4 days (range 2-365). Thirty per cent of responders never prescribed uricosuric agents. The estimated rate of occurrence of treatment-induced attacks increased with the reported interval between the attack and initiation of urate-lowering therapy. Our data demonstrate that French rheumatologists have widely diverging views on how to treat gout. Whether a waiting period is needed between an acute attack and initiation of urate-lowering therapy, and how long this period should be, are unsettled issues that deserve to be studied.
Rozenberg
S
S
Department of Rheumatology, Pitié Teaching Hospital, Paris.
Lang
T
T
Laatar
A
A
Koeger
A C
AC
Orcel
P
P
Bourgerois
P
P
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D015210:Arthritis, Gouty / Q000188:drug therapy*; D001291:Attitude of Health Personnel; D003078:Colchicine / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005602:France; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D006074:Gout Suppressants; D003078:Colchicine