AB1062 EVALUATION OF THE EFFECTIVENESS OF GOUT THERAPY IN OUTPATIENT PRACTICE

Abstract

Background: gout is a socially signifcant pathology, as it affects men of working age and is associated with the development of cardiovascular diseases. Meanwhile, according to studies, most patients with gout do not reach the target values of uric acid (UA). Objectives: to evaluate the effectiveness of gout therapy in real clinical practice and to identify factors that improve this indicator. Methods: The study included patients with an established diagnosis of gout (according to ACR/EULAR criteria). Depending on the stage of the disease, patients were prescribed symptomatic anti-infammatory therapy, and urate-low-ering therapy (UST)-allopurinol or febuxostat-to reduce the level of UA. The dosage of allopurinol in the frst 2 months of admission was 300 mg/day and then adjusted depending on the level of UA, the dosage of febuxostat was 80 mg, adjusted to 120 mg if necessary. To prevent exacerbation, all patients were prescribed colchicine 0.5-1.0 mg/day for up to 6 months. After 2 and 6 months of therapy, the effectiveness of it was assessed. All patients had a conversation about the correction of risk factors (diet, alcohol intake) and recommendation to watch online educational school for patients with gout. Results: the average age of 60 patients included in the study was 46.9±9.9 years, the duration of the disease was 8.5±3.4 years, of which 96.7% were men. The mean number of exacerbation per year prior to therapy was 7.8±3.5. After 6 months of therapy, 46.7% of patients noted the absence of gout attacks, the rest-a decrease in the duration of attacks (from 10.4 to 1. 6 days on average) and their intensity (the average pain during an attack on the VAS scale decreased from 7. 8 points up to 3.9). The average level of UA decreased over 2 months from 541.3±146.8 to 387.4±146.9 μ mol/l, and after six months of admission it was 299.6±56.5 μ mol/l. The creatinine level did not change signifcantly and amounted to 104.7±34.9 μ mol/l before therapy and 97.5±26.7 μ mol/l after 6 months. None of the patients discontinued therapy due to intolerance; one of the patients experienced a slight leukopenia while taking febux-ostat, which did not lead to discontinuation of the drug. It should be noted that the majority of the subjects-56.7%-had previously consulted a rheumatolo-gist, but most of them did not receive permanent therapy. Patients highlighted qualitative information and the effect of treatment as the most important reasons for continuing therapy. Conclusion: This study proves that achieving the target level of UA is possible in most patients with gout, leads to a signifcant reduction in the number of attacks and their severity, requires educational work and patient monitoring. It is important that this work is part of a planned 2-year follow-up of patients with gout in order to determine the long-term effectiveness of therapy.