To treat or not to treat asymptomatic hyperuricemia

Abstract

Background: Hyperuricemia is a term given to serum uric acid levels higher than 7.0 mg/dL; asymptomatic hyperuricemia may precede gouty attacks with several years. This progression is variable from a person-to-person and may not even develop. Owing to this, there is a great controversy in whether to treat asymptomatic hyperuricemia or not. Objective: The objective of the following study is to determine the treatment habits of asymptomatic hyperuricemia in Makkah Region, Kingdom of Saudi Arabia. Materials and Methods: This survey was carried out using a structured questionnaire that was answered through face-to-face interviews with 104 physicians who diagnose and treat hyperuricemia. The data was collected on the second half of 2012. The specialties included in the study were general practitioners, family physicians, orthopedicians and rheumatologists. Results: Half of the doctors in our study (50.9%) chose to observe and follow asymptomatic hyperuricemic patients and 84% depend on the serum uric acid levels to help them decide when to start their treatment, 53% asked about co-morbid diseases as renal stones, diabetes mellitus and ischemic heart disease whereas 49% asked about family history. When doctors are to start the treatment, 84.1% will start with allopurinol and 42.5% will advise on the change of dietary and life-style habits. Conclusions: The results showed that the doctors in Makkah Region depend on the serum uric acid levels to decide when to start the treatment, not abiding by the international guidelines. They still chose the life-style and dietary modification, as well as starting treatment with allopurinol with a starting dose of 100 mg/dL daily.