Current gout treatment and flare in South Korea: Prophylactic duration associated with fewer gout flares.

Abstract

To evaluate treatment patterns and clinical factors affecting gout flare in South Korea. We retrospectively examined data from 401 patients seen at nine rheumatology multicenter clinics, under urate lowering therapy (ULT) more than 6months after stopping prophylactic medication. Demographic data, clinical and laboratory features were collected at the initiation of ULT, upon stopping prophylaxis, and 6months after. The mean age was 52.2years and mean disease duration was 25.0months. The male-to-female count was 387:14. The most common ULT starting agent was allopurinol 83.8%. Colchicine (62.3%) was the most commonly prescribed prophylactic agent. During ULT, 134 of the 401 patients (33.4%) experienced at least one gouty attack in the period from stopping prophylaxis to 6months later. The duration of prophylaxis was different between those with serum uric acid levels below 6mg/dL and those over 6mg/dL (P=0.001). Of the 179 patients (44.6%) who attained target serum uric acid (SUA) levels (6mg/dL) at the end of prophylaxis, those taking <6months of prophylaxis suffered more frequent flares than those taking it ≥6months (42.9% vs. 26.3%, P=0.041). The time interval to the first attack after stopping prophylaxis was shorter in the <6months group than the ≥6months group (13.5weeks vs. 22.5weeks, P=0.007). Prophylaxis more than 6months from initiation of ULT, and achieving target SUA (<6mg/dL) at the time of stopping prophylaxis is associated with fewer gout flares during ULT.