title: Outcome of Treatment in Gouty Arthritis Patients: A Retrospective Study.
abstract: BACKGROUND
  Effective treatment in gouty arthritis can prevent joint and renal damage. Target serum uric acid levels of < 6 mg/dl and < 5 mg/dl are recommended in gouty arthritis and those with tophi, respectively.
  
  
  OBJECTIVE
  To evaluate: (i) whether patients achieved recommended serum uric acid target and assess influencing factors and (ii) renal function between patients who achieved and not achieved the goal.
  
  
  METHODS
  The medical records of gouty arthritis patients treated in outpatient department at Thammasat University Hospital between January 2013 and December 2013 were reviewed. Patients were divided into adequately (ATG) and inadequately treated groups (ITG) based on the ACR uric acid criteria after six months of treatment. Factors associated with inadequate treatment were explored and post treatment renal function compared between A and ITGs.
  
  
  RESULTS
  Of 139 patients, 46 (33%) achieved target serum uric acid concentrations. Alcoholic consumption was the significant factor influencing the outcome. 75.5% of patients were followed-up > 1 month for second evaluation of uric acid and most of them not receiving dosage up-titration even though not achieving the target. Both groups had similar alterations of renal function after treatment (p = 0.68).
  
  
  CONCLUSIONS
  Most patients failed to achieve recommended uric acid targets. Alcohol consumption was identified as a key risk factorfor a suboptimal outcome. The treat-to-target approach should be underlined. Other risk factors should be explored prospectively.
authors.forename: Punchong
authors.initials: P
authors.lastname: Hanvivadhanakul
authors.forename: Ratchapruk
authors.initials: R
authors.lastname: Wongdet
mesh_terms: D000428:Alcohol Drinking / Q000097:blood; D000493:Allopurinol / Q000097:blood / Q000627:therapeutic use*; D015210:Arthritis, Gouty / Q000097:blood / Q000188:drug therapy*; D001553:Benzbromarone / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006074:Gout Suppressants / Q000097:blood / Q000627:therapeutic use; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D014527:Uric Acid / Q000097:blood; D014528:Uricosuric Agents / Q000097:blood / Q000627:therapeutic use
chemical_list: D006074:Gout Suppressants; D014528:Uricosuric Agents; D014527:Uric Acid; D001553:Benzbromarone; D000493:Allopurinol