Rheumatology Medical News about urate-lowering therapies;treatment of gout

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Adherence with urate-lowering therapies for the treatment of gout
Arthritis Research & Therapy, 04/01/09

Harrold LR et al. – Study reports that nonadherence amongst gout patients initiating urate-lowering therapies (ULDs) is exceedingly common, particularly in younger pts with less comorbidity and no provider visits for gout prior to ULD initiation.

Methods

Study to assess the level and determinants of nonadherence with ULDs prescribed for gout
Subjects ≥18 yrs with a diagnosis of gout who initiated use of allopurinol, probenecid, or sulfinpyrazone from Jan 1, 2000-June 30, 2006
Nonadherence was measured using the medication possession ratio over the first year of therapy and defined as an MPR < 0.8
Descriptive statistics calculated and logistic regression used to estimate the strength of association between patient characteristics and nonadherence

Results

4,166 gout pts who initiated ULDs; 97% received allopurinol
Median MPR for any ULD use was 0.68
56% pts were nonadherent
Predictors of poor adherence:
- younger age
- fewer comorbid conditions
- no provider visits for gout prior to ULD initiation
- and use of NSAIDs in the year prior to ULD initiation

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