POS1161 CAN DOCTORS TREAT GOUT WELL? INSIGHT ON GOUT MANAGEMENT IN REFERRAL CENTRES

Abstract

Background: Recent studies have shown a lack of implementation of gout recommendations in primary care. In this context of therapeutic inertia, the French Society of Rheumatology (SFR) published its frst recommendations on gout (RECO) in 2020 [1,2], which were deliberately simple and concise. Objectives: To determine the profile of patients referred to French gout expert centres, and to examine the results of their management. Methods: Three hundred patients attending a frst visit for gout management in three French referral centres were retrospectively included. Visits were performed at baseline (M0) and scheduled for month 6 (M6), month 12 (M12), and month 24 (M24). Data collected included: patient profile; disease activity and treatments; serum urate (SU) level; estimated glomerular fltration rate (eGFR). Results: Patients were 81% male, mean age 62.2 ± 15.2 years, 42.7% prevalence of eGFR <60ml/min/1.73m2, 28.1% diabetes mellitus, and 25.4% had a history of major cardiovascular event. Management followed French recommendations after the baseline visit in 94.9% of cases. Overall, 50 patients (16.7%) received off-label anakinra for fare treatment or fare prophylaxis. SU levels were below 6.0mg/dL in 59.4% of patients at M6, 67.9% at M12, and 78.6% at M24. At M24, 50% of patients were treated with allopurinol (313 ± 105 mg/d), which exceeded renal restrictions of doses in 61.5% of them, and 48.2% received febuxostat (84 ± 36mg/d). At inclusion, 94% of patients had experienced at least one fare in the previous six months, versus 23.6% at M12, and 13.1% at M24 (of which 8/12 (66.7%) had SU>6.0mg/dL). Conclusion: Simple application of gout management guidelines is feasible in clinical practice, and is efficient with a majority of patients achieving SU targets and clinical improvement. A minority of patients in referral centres have 'diffi-cult-to-treat' gout requiring specifc management.