Factors Affecting the Successful Treatment in Gouty Arthritis Patients at Nongkhai Hospital
Jintara Mangkala¹
Affiliation : ¹ Division of Internal Medicine, Nongkhai Hospital, Nong Khai, Thailand
Background: Gout is the most common inflammatory arthritis worldwide, with a prevalence ranging from less than 1% to 6.8% and an incidence of 0.58 to 2.89 per 1,000 cases per year, depending on the study. However, there are still problems in terms of diagnosis and treatment.
Objective: To evaluate 1) the factors affecting the successful treatment in gouty arthritis patients, 2) the prevalence, patients’ characteristics, and factors associated with gouty arthritis, and 3) the problems of the diagnosis and treatment of gouty arthritis patients at Nongkhai Hospital, Thailand.
Materials and Methods: The medical records of gouty arthritis patients treated in the outpatient department at Nongkhai Hospital between July 2010 and December 2020 were reviewed. Patients were divided into successfully treated group (STG) and unsuccessfully treated group (UTG) based on target uric acid level throughout the treatment. Factors affecting the successful treatment including address, nationality, age, gender, body mass index (BMI), duration of disease, presence of tophi, alcoholic intake, medical illness, medications, duration of treatment, physicians’ specialties, uric acid levels, glomerular filtration rate (GFR), alanine aminotransferase (ALT) before and after treatment, history of drugs discontinuation, and follow up were explored.
Results: Of the 804 patients, 74.3% and 70.3% of patients achieved target uric acid level at one year and throughout treatment, respectively. Factors affecting the successful treatment were GFR before treatment of 60 or more mL/minute/1.73 m² (p=0.001), absence of tophi (p=0.023), and physicians’ specialties (p=0.001).
Conclusion: The improvement of the physician’s education and treatment, close monitoring of patients with tophi, and GFR before treatment will increase the success of treatment and reduce complications.
Received 16 August 2021 | Revised 17 January 2022 | Accepted 17 January 2022
DOI: 10.35755/jmedassocthai.2022.02.13271
Keywords : Gout; Gouty arthritis; Tophi; Hyperuricemia; Outcome; Treatment; Predictor
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