title: Characteristics and management of gout patients in Europe: data from a large cohort of patients.
abstract: OBJECTIVE
  To increase the knowledge of epidemiology and treatment of gout in a 'real-life' setting, we conducted a large observational analysis (CACTUS) in two European countries, namely France and Greece.
  
  
  METHODS
  This was a multicenter, cross-sectional, observational analysis, conducted in France and Greece. The analysis was conducted in a field-practice scenario, with both general practitioners and rheumatologists recruiting patients for inclusion. Treatment methods and drug prescriptions were left to the sole initiative of the participating physicians. A number of epidemiological and clinical characteristics were recorded in a single inclusion visit. Compliance to maintenance treatment was also monitored after the inclusion visit by monthly interview.
  
  
  RESULTS
  In total 3079 patients were included. Hypertension was the most common co-morbidity (68%), followed by hypercholesterolemia (59%) and obesity (48%). Mean serum Uric Acid (sUA) concentration was 8.7 mg/dl. Almost all patients received life-style or dietary recommendations. At inclusion, 81.5% of patients were on a urate-lowering treatment. Most of these patients had been treated with allopurinol; this treat-ment had been interrupted for lack of reduction of sUA levels below 6 mg/dl (47%), lack of symptom relief (34%) or poor compliance (23%). At the inclusion visit, 98% of the patients were prescribed an urate-lowering treatment: 87% received febuxostat and 12% allopurinol alone. Satisfactory or very satisfactory compliance to febuxostat was recorded in 92% of the patients, versus 82% in patients on allopurinol.
  
  
  CONCLUSIONS
  CACTUS provides an overview of characteristics of gouty patients and gout management. Education of patients by healthcare providers seem to be a pre-requisite to optimize the management of gout, a condition which remains poorly man-aged.
authors.affiliation: Université Paris Diderot, UFR Médicale, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, Paris Cedex 10, France.
authors.forename: P
authors.initials: P
authors.lastname: Richette
authors.forename: R N
authors.initials: RN
authors.lastname: Flipo
authors.forename: D K
authors.initials: DK
authors.lastname: Patrikos
mesh_terms: D000328:Adult; D000493:Allopurinol / Q000627:therapeutic use; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005060:Europe / Q000453:epidemiology; D000069465:Febuxostat; D005260:Female; D005602:France / Q000453:epidemiology; D006073:Gout / Q000097:blood / Q000453:epidemiology* / Q000628:therapy*; D006074:Gout Suppressants / Q000627:therapeutic use; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy; D010349:Patient Compliance; D013844:Thiazoles / Q000627:therapeutic use; D014527:Uric Acid / Q000097:blood
chemical_list: D006074:Gout Suppressants; D013844:Thiazoles; D000069465:Febuxostat; D014527:Uric Acid; D000493:Allopurinol