Background Many guidelines from different parts of the world mention the impact of diet on gout (1). However, data are scarce in sub-Saharan Africa.
Objectives To evaluate the efficacy and safety of a gouty apurinic personalized diet based on ethnic origin, dietary habits and patient comorbidities.
Methods Gout (177 ACR preliminary criteria) patients with serum urate levels >70g/dL were recruited. Patients were randomized to receive a standard diet apurinic gout or a personalized diet. At 1 month, all patients in the standard diet group were put under the personalized diet.
The primary endpoint was the reduction of serum uric acid at 1 month (M1) and 3 months (M3). Secondary outcomes were the number of gout attacks and changes in anthropometric measures at M1 and M3. A p<0.05 was considered statistically significant.
Results Of the 30 patients randomized, 12 patients have not respected their diet. Only 18 were retained in the final analysis: 10 patients on personalized diet group and 8 on standard diet group. The baseline characteristics of both groups were similar at baseline (p>0.05). At M1, we have observed a significant decrease in serum uric acid in the personalized diet group compared to the standard diet group (p=0.0001). We have observed 5 acute gout attacks in the standard diet group against 2 acute gout attacks in the personalized diet group (p=0.03). A trend of decrease was observed for all other parameters without significance (p>0.05) [Table 1].
At M3, all patients received personalized diet. Initial efficacy was maintained in all the patients of the personalized diet group. For patients of the standard diet group, we observed a significant decrease in serum uric acid (p=0.02). There was no difference in the number of acute gout attacks (p=0.08). A trend of decrease was also observed for all other parameters without significance (Table 1).
No adverse events related to both diet group were observed.
Conclusions This study shows that the diet should be personalized in gouty patients according to socio-cultural environment, lifestyle, and comorbidities of each patients. Efforts should be made to improve compliance to diet like other non-pharmacological and pharmacological treatment.
Khanna D et al. Arthritis Care Res (Hoboken) 2012;64:1447–61.
Disclosure of Interest None declared