title: A survey on the management of gout in Malaysia.
abstract: 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.
authors.affiliation: Sime Darby Medical Centre Subang Jaya, Subang Jaya, Selangor, Malaysia. yeapss@myjaring.net
authors.forename: Swan Sim
authors.initials: SS
authors.lastname: Yeap
authors.forename: Emily M L
authors.initials: EM
authors.lastname: Goh
authors.forename: Suk Chyn
authors.initials: SC
authors.lastname: Gun
mesh_terms: 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
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D005938:Glucocorticoids; D006074:Gout Suppressants; D014527:Uric Acid; D000493:Allopurinol; D003078:Colchicine