Background Gout is one of the most prevalent rheumatic conditions in the developing world, due of the aging of the population and the modifications in the life style. The 2014 EULAR recommendations for the management of gout have defined the therapeutic target of 60 mg/L for gouty patients (recommendation 8). The aim of the study was to assess the adherence of Algerian patients with gout to these recommendations.
Methods We have retrospectively analyzed patients files aged 18 and more, followed in a rheumatology setting for gout, in 4 centers in Algeria. Demographic, clinical and lab data were collected. We have excluded files with missing data. Were noted the used therapeutics and serum uric acid in every patient through time. Tolerance was noted.
Results We have analyzed 145 complete files: 98 men (68%), with a mean age of 65.4±11.4 years. All patients except two had rheumatic manifestations, 20 patients had renal insufficiency and 15 had tophi. Main comorbidities were hypertension (40 patients) and diabetes (25 patients). The mean serum uric acid level was 96±14 mg/L. Concerning symptomatic drugs, 81 patients have taken colchicine and 15 NSAIDs, the remaining patients have taken other drugs or combination therapy. All patients but one have received serum uric acid lowering therapy (allopurinol in majority of cases), with a median dosage of 200 mg/day, and only 5 patients taking more than 300mg/day. The mean serum uric acid level at 6 months was 58±14 mg/L, with 58% of patients achieving a level of <60 mg/L.
Conclusions In rheumatology settings in Algeria, more than 93% of gouty patients received allopurinol, with an excellent tolerance. However, it seems that dosage is insufficient, with only 58% of patients achieving the EULAR recommendation 8. More efforts have to be provided to optimize this therapy.
Disclosure of Interest None declared