A patient with hyperuricemia at an initial outpatient appointment with a rheumatologist: focus on adherence to urate-lowering therapy

Abstract

Hyperuricemia (HU) is a key risk factor for the development of gout and chronic kidney disease. The goal of HU therapy is to reduce the level of urate in the blood serum, helping to reduce exacerbations of gout, resolve tophi and prevent kidney damage. Purpose. To analyze the effectiveness of previous urate-lowering therapy (ULT) and treatment adherence in patients with HU. Material and methods. The study involved 38 patients with HU and articular syndrome. The survey included information about the frequency of patients' visits to a rheumatologist, their adherence to a hypouricemic diet, the regularity and duration of taking urate-lowering drugs, their dose, and the frequency of determining the level of uric acid (UA) in the blood. Results. 50% of patients complied with recommendations on non-pharmacological measures for HU. 32 patients had indications for ULT, of which 28.1% received this therapy. Of these, 8 patients took allopurinol (100–200 mg/day), 1 patient took febuxostat (80 mg/day). Determination of UA level in all cases was carried out no more than once a year. Dose adjustment of urate-lowering drugs based on UA levels was not performed in any case. During the last year, 13.2% of patients were examined by a rheumatologist. Conclusion. Adherence to ULT and monitoring of serum UA levels among patients with HU/gout remains low. Patients in most cases do not achieve target UA values, which leads to the development and more severe course of comorbid diseases and complications of gout.