Achievement of the target serum urate level among patients with gout treated with allopurinol or febuxostat in an arthritis clinic in the Philippines.

Objective: Gout is an important cause of disability among Filipinos, despite measures for effective management. This study aims to determine attainment of target serum uric acid level (SUA ≤ 6 mg/dl) among patients with gout given urate-lowering therapy (ULT) over 6-12 months.

Methods: This is a single-center, prospective cohort study conducted in one adult Arthritis Clinic at the University of the Philippines-Philippine General Hospital which included 138 patients with gout (1977 ACR criteria), SUA ≥ 6 mg/dl prior to ULT, initiated on ULT (allopurinol or febuxostat), with six months minimum follow-up and with SUA determination post-treatment.

Results: 37.7% (52/138) and 36.2% (50/138), achieved target SUA at 6 and 12 months. The factors associated with achieving target SUA in 6 months are BMI > 25 kg/m [OR 6.98, 95% confidence interval (CI) 1.44-33.88, value = .016], allopurinol dose ≥ 300 mg (OR 15.76, 95% CI 2.24-111.06, value = .006), and baseline SUA (OR 0.52, 95% CI 0.33-0.82, value = .005). The factors associated with achieving target SUA in 12 months are employment (OR 5.51, 95% CI 1.00-30.33, value = .050), baseline SUA (OR 0.45, 95% CI 0.28-0.74, value = .002), and age at onset of gout (OR 1.08, 95% CI 1.01-1.15, value = .026).

Conclusion: Target SUA level was not achieved at 6 and 12 months of ULT in most of this cohort. This mirrors the deficient control of gout and should urge health professionals to fully study and address the problem.