Gout often diagnosed late, poorly managed

A survey of European patients with gout showed that general practitioners, and not rheumatologists, are overwhelmingly diagnosing and managing the disease, according to findings presented at the EULAR Annual Congress.

“Although it is easily treatable, there are significant gaps in the current management of gout,” Marc de Meulemeester, MD, a general practitioner at MEDIF sprl in Gozée, Belgium, said in a press release.

The researchers offered a 15-minute online survey for 1,100 gout patients in 14 countries across Europe. Data showed that these patients experienced a mean number of 2.9 flares in the past year.

General practitioners, and not rheumatologists, are overwhelmingly diagnosing and managing the disease, according to findings.

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More than three-quarters of the cohort (77%) had comorbidities, including hypertension (52%), dyslipidemia (41%), and overweight (40%), type 2 diabetes 23% and long-term illness of kidney/renal insufficiency (17%).

Results showed that general practitioners diagnosed 73% of cases, while rheumatologists diagnosed just 8%. Similarly, general practitioners were more likely to discuss the disease with their patients, 68% vs. 15%. For the last gout flare reported by respondents, 59% had been treated by general practitioners and just 11% had been treated by rheumatologists.

Other findings showed that 22% of patients had failed to be diagnosed until after four or more flares, while 71% had experienced flares in the previous year.

Treatment-related findings showed that 58%were receiving uric acid lowering therapies, 43% were being treated with painkillers, 25% with colchicine, 13% with nonmedical pain relief, and 12% with corticosteroids.

Nearly 60% of the cohort reported that they did not have routine follow-up appointments to manage their gout, while 53% are monitored for serum uric acid less than twice a year. However, 79% of respondents reported being satisfied with their treatment plan and have no other expectations for management of their gout.

“Our results demonstrate that, across Europe, gout has a significant impact on the lives of patients and their families,” de Meulemeester, said. “This should be a call to action to educate patients and their doctors about adequate management of gout.” – by Rob Volansky

Reference:

Meulemeester MD, et al. OP0157-HPR. Presented at: EULAR Annual Congress; June 12-15, 2019; Madrid.

Disclosure: Meulemeester reports consulting for Grünenthal and being on the speakers; bureau of AstraZeneca and Novartis.