A survey on the management of gout in Malaysia.
OBJECTIVE
The aim of this study was to ascertain the management of gout by doctors in Malaysia.


METHODS
A cross-sectional questionnaire survey was carried out among doctors attending rheumatology post-graduate courses, where gout was not a lecture topic.


RESULTS
A total of 128 questionnaires were analyzed, of which the majority (67: 52.3%) were general practitioners. In the treatment of acute gout, 68.0% use non-selective non-steroidal anti-inflammatory drugs (NSAIDs), 53.9% use selective COX-2 inhibitors (coxibs), 66.4% use colchicine and 10.2% use allopurinol (ALLO). In the treatment of chronic gout, 36.7% use NSAIDs, 44.5% use coxibs, 19.5% use colchicine and 93% use ALLO. In both acute and chronic gout, corticosteroids (CS) are not used by over 90% of respondents. Fifty percent would stop ALLO during an acute attack. 95.3% do not start ALLO during an acute attack; 87.5% would start ALLO after the attack, with a median of 14 days afterwards. Once ALLO was started, 54.7% would continue indefinitely. Regarding target urate levels while on treatment, 10.9% would be satisfied with a high normal range, 21.9% middle of the range, 18.0% low normal range and 45.3% anywhere within the normal range. Fifteen percent would treat asymptomatic hyperuricemia.


CONCLUSIONS
In Malaysia, anti-inflammatory agents are most commonly used for the treatment of acute and chronic gout, with corticosteroid usage at a low level. However, there are areas of concern regarding the diagnosis of gout and the usage of ALLO which are not consistent with current guidelines.
Yeap
Swan Sim
SS
Sime Darby Medical Centre Subang Jaya, Subang Jaya, Selangor, Malaysia. yeapss@myjaring.net
Goh
Emily M L
EM
Gun
Suk Chyn
SC
D000208:Acute Disease; D000493:Allopurinol / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D002908:Chronic Disease; D003078:Colchicine / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006073:Gout / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D008296:Malaysia; D011320:Primary Health Care / Q000706:statistics & numerical data; D011364:Professional Practice / Q000706:statistics & numerical data; D012016:Reference Values; D011795:Surveys and Questionnaires; D014527:Uric Acid / Q000097:blood
D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D005938:Glucocorticoids; D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol; D003078:Colchicine