title: Current gout treatment and flare in South Korea: Prophylactic duration associated with fewer gout flares.
abstract: OBJECTIVE
  To evaluate treatment patterns and clinical factors affecting gout flare in South Korea.
  
  
  METHODS
  We retrospectively examined data from 401 patients seen at nine rheumatology multicenter clinics, under urate lowering therapy (ULT) more than 6 months after stopping prophylactic medication. Demographic data, clinical and laboratory features were collected at the initiation of ULT, upon stopping prophylaxis, and 6 months after.
  
  
  RESULTS
  The mean age was 52.2 years and mean disease duration was 25.0 months. The male-to-female count was 387 : 14. The most common ULT starting agent was allopurinol 83.8%. Colchicine (62.3%) was the most commonly prescribed prophylactic agent. During ULT, 134 of the 401 patients (33.4%) experienced at least one gouty attack in the period from stopping prophylaxis to 6 months later. The duration of prophylaxis was different between those with serum uric acid levels below 6 mg/dL and those over 6 mg/dL (P = 0.001). Of the 179 patients (44.6%) who attained target serum uric acid (SUA) levels (6 mg/dL) at the end of prophylaxis, those taking < 6 months of prophylaxis suffered more frequent flares than those taking it ≥ 6 months (42.9% vs. 26.3%, P = 0.041). The time interval to the first attack after stopping prophylaxis was shorter in the < 6 months group than the ≥ 6 months group (13.5 weeks vs. 22.5 weeks, P = 0.007).
  
  
  CONCLUSIONS
  Prophylaxis more than 6 months from initiation of ULT, and achieving target SUA (< 6 mg/dL) at the time of stopping prophylaxis is associated with fewer gout flares during ULT.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Hyo Jin
authors.initials: HJ
authors.lastname: Choi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, NHIS Ilsan Hospital, Goyang-si, Korea.
authors.forename: Chan Hee
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea.
authors.forename: Joo Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Ilsan, Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Yoon
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Hyoun Ah
authors.initials: HA
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea.
authors.forename: Chang Hee
authors.initials: CH
authors.lastname: Suh
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Choong Ang University Hospital, Seoul, Korea.
authors.forename: Sang Tae
authors.initials: ST
authors.lastname: Choi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Choong Ang University Hospital, Seoul, Korea.
authors.forename: Jung Soo
authors.initials: JS
authors.lastname: Song
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Inha University Hospital, Incheon, Korea.
authors.forename: Ho Yeon
authors.initials: HY
authors.lastname: Joo
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea.
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Choi
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Ewha Womans University Medical Center, Incehon, Korea.
authors.forename: Ji Soo
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Kee Chul
authors.initials: KC
authors.lastname: Shin
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Han Joo
authors.initials: HJ
authors.lastname: Baek
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D004334:Drug Administration Schedule; D005260:Female; D006073:Gout / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood
chemical_list: D015415:Biomarkers; D006074:Gout Suppressants; D014527:Uric Acid
keywords: flare; gout treatment; prophylactic duration; serum uric acid