Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone
Aim: This study aims to assess outcomes of gout patients from the treat to target (T2T) perspective at 6 months and 12 months while using urate lowering therapy (ULT): allopurinol, febuxostat, and/or benzbromarone. Methods: All gout patients visiting the Rheumatology department between 2015 to 2021...
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| Format: | Article |
| Language: | English |
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Open Exploration Publishing Inc.
2023-08-01
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| Series: | Exploration of Musculoskeletal Diseases |
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| Online Access: | https://www.explorationpub.com/uploads/Article/A100714/100714.pdf |
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| author | Ioana Hotea Tanja Giesen Antoaneta Comarniceanu Monique Efde Frits van Osch Matthijs Janssen Tim L. Jansen |
| author_facet | Ioana Hotea Tanja Giesen Antoaneta Comarniceanu Monique Efde Frits van Osch Matthijs Janssen Tim L. Jansen |
| author_sort | Ioana Hotea |
| collection | DOAJ |
| description | Aim: This study aims to assess outcomes of gout patients from the treat to target (T2T) perspective at 6 months and 12 months while using urate lowering therapy (ULT): allopurinol, febuxostat, and/or benzbromarone. Methods: All gout patients visiting the Rheumatology department between 2015 to 2021 were identified from the digital hospital system. The diagnosis of gout was based on the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2015 classification criteria. Patient outcomes were predefined intention to treat (ITT) categories: category 1: patients with serum uric acid (sUA) ≤ 0.360 mmol/L (ACR target for gout); category 2: patients with sUA ≤ 0.300 mmol/L (ACR/EULAR target for severe gout); category 3: patients with sUA > 0.360 (failure to meet ACR target). Results: Gout diagnoses were present in 1,186 patients: 986 (83.1%) males and 200 (16.9%) females. A follow-visit at 6 months was present in 76.9% (n = 856) out of 1,113 patients reaching sUA < 0.36 mmol/L, but 257 (23%) failed to reach the 0.36 mmol/L target. At 12 months, a follow-up visit was available in 792 (71.1%) patients, and from these, 710 (90%) had reached sUA < 0.36 mmol/L target. The use of benzbromarone was a strong predictor of reaching the sUA < 0.30 mmol/L target: odds ratio (OR) 3.2, 95% confidence interval (CI) (1.735, 6.017) at 6 months. Diabetic patients had the highest proportion of not reaching the target: 18%. Male patients needed higher dosages of allopurinol to reach the sUA target at 6 months compared to female patients. Conclusions: This is a large study on a T2T approach based in a real-life clinical setting. Only 42% reached the sUA target at 6 months with allopurinol 300 mg quaque die (QD) monotherapy. About 77% of gout patients reach the predefined sUA target of 0.36 mmol/L at 6 months with the availability of three ULTs. There is still a significant unmet need in gout as many patients failed to achieve predefined sUA targets. |
| format | Article |
| id | doaj-art-6e7a8346bb4c48e2bf6a196b369f521b |
| institution | Matheson Library |
| issn | 2836-6468 |
| language | English |
| publishDate | 2023-08-01 |
| publisher | Open Exploration Publishing Inc. |
| record_format | Article |
| series | Exploration of Musculoskeletal Diseases |
| spelling | doaj-art-6e7a8346bb4c48e2bf6a196b369f521b2025-07-29T02:30:47ZengOpen Exploration Publishing Inc.Exploration of Musculoskeletal Diseases2836-64682023-08-01149710510.37349/emd.2023.00014Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromaroneIoana Hotea0https://orcid.org/0000-0003-2552-9835Tanja Giesen1https://orcid.org/0000-0002-1632-4232Antoaneta Comarniceanu2https://orcid.org/0000-0003-1269-820XMonique Efde3https://orcid.org/0000-0002-0854-4374Frits van Osch4https://orcid.org/0000-0003-4329-2560Matthijs Janssen5https://orcid.org/0000-0003-3700-6257Tim L. Jansen6https://orcid.org/0000-0003-3026-3154Department of Rheumatology, VieCuri Medical Centre, 5912BL Venlo, The Netherlands; Department of Rheumatology, University of Medicine and Pharmacy “Iuliu Hatieganu”, 400012 Cluj-Napoca, RomaniaDepartment of Rheumatology, VieCuri Medical Centre, 5912BL Venlo, The NetherlandsDepartment of Rheumatology, VieCuri Medical Centre, 5912BL Venlo, The NetherlandsDepartment of Rheumatology, VieCuri Medical Centre, 5912BL Venlo, The NetherlandsLeerhuis, VieCuri Medical Centre, 5912BL Venlo, The NetherlandsDepartment of Rheumatology, VieCuri Medical Centre, 5912BL Venlo, The NetherlandsDepartment of Rheumatology, VieCuri Medical Centre, 5912BL Venlo, The Netherlands; Department of Medical Cell BioPhysics (MCB), University of Twente, 7522NB Enschede, The NetherlandsAim: This study aims to assess outcomes of gout patients from the treat to target (T2T) perspective at 6 months and 12 months while using urate lowering therapy (ULT): allopurinol, febuxostat, and/or benzbromarone. Methods: All gout patients visiting the Rheumatology department between 2015 to 2021 were identified from the digital hospital system. The diagnosis of gout was based on the American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2015 classification criteria. Patient outcomes were predefined intention to treat (ITT) categories: category 1: patients with serum uric acid (sUA) ≤ 0.360 mmol/L (ACR target for gout); category 2: patients with sUA ≤ 0.300 mmol/L (ACR/EULAR target for severe gout); category 3: patients with sUA > 0.360 (failure to meet ACR target). Results: Gout diagnoses were present in 1,186 patients: 986 (83.1%) males and 200 (16.9%) females. A follow-visit at 6 months was present in 76.9% (n = 856) out of 1,113 patients reaching sUA < 0.36 mmol/L, but 257 (23%) failed to reach the 0.36 mmol/L target. At 12 months, a follow-up visit was available in 792 (71.1%) patients, and from these, 710 (90%) had reached sUA < 0.36 mmol/L target. The use of benzbromarone was a strong predictor of reaching the sUA < 0.30 mmol/L target: odds ratio (OR) 3.2, 95% confidence interval (CI) (1.735, 6.017) at 6 months. Diabetic patients had the highest proportion of not reaching the target: 18%. Male patients needed higher dosages of allopurinol to reach the sUA target at 6 months compared to female patients. Conclusions: This is a large study on a T2T approach based in a real-life clinical setting. Only 42% reached the sUA target at 6 months with allopurinol 300 mg quaque die (QD) monotherapy. About 77% of gout patients reach the predefined sUA target of 0.36 mmol/L at 6 months with the availability of three ULTs. There is still a significant unmet need in gout as many patients failed to achieve predefined sUA targets.https://www.explorationpub.com/uploads/Article/A100714/100714.pdfreal-life studygouturate lowering therapyshared decision-making |
| spellingShingle | Ioana Hotea Tanja Giesen Antoaneta Comarniceanu Monique Efde Frits van Osch Matthijs Janssen Tim L. Jansen Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone Exploration of Musculoskeletal Diseases real-life study gout urate lowering therapy shared decision-making |
| title | Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone |
| title_full | Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone |
| title_fullStr | Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone |
| title_full_unstemmed | Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone |
| title_short | Real-life results of urate-driven pharmacotherapy with three urate lowering drugs in gout: allopurinol, febuxostat and benzbromarone |
| title_sort | real life results of urate driven pharmacotherapy with three urate lowering drugs in gout allopurinol febuxostat and benzbromarone |
| topic | real-life study gout urate lowering therapy shared decision-making |
| url | https://www.explorationpub.com/uploads/Article/A100714/100714.pdf |
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