Characteristics and management of gout patients in Europe: data from a large cohort of patients

Abstract

Objective: To increase the knowledge of epidemiology and treatment of gout in a 'real-life' setting, we conducted a large observational analysis (CACTUS) in two European countries, namely France and Greece.

Patients and methods: This was a multicenter, cross-sectional, observational analysis, conducted in France and Greece. The analysis was conducted in a field-practice scenario, with both general practitioners and rheumatologists recruiting patients for inclusion. Treatment methods and drug prescriptions were left to the sole initiative of the participating physicians. A number of epidemiological and clinical characteristics were recorded in a single inclusion visit. Compliance to maintenance treatment was also monitored after the inclusion visit by monthly interview.

Results: In total 3079 patients were included. Hypertension was the most common co-morbidity (68%), followed by hypercholesterolemia (59%) and obesity (48%). Mean serum Uric Acid (sUA) concentration was 8.7 mg/dl. Almost all patients received life-style or dietary recommendations. At inclusion, 81.5% of patients were on a urate-lowering treatment. Most of these patients had been treated with allopurinol; this treat-ment had been interrupted for lack of reduction of sUA levels below 6 mg/dl (47%), lack of symptom relief (34%) or poor compliance (23%). At the inclusion visit, 98% of the patients were prescribed an urate-lowering treatment: 87% received febuxostat and 12% allopurinol alone. Satisfactory or very satisfactory compliance to febuxostat was recorded in 92% of the patients, versus 82% in patients on allopurinol.

Conclusions: CACTUS provides an overview of characteristics of gouty patients and gout management. Education of patients by healthcare providers seem to be a pre-requisite to optimize the management of gout, a condition which remains poorly man-aged.