Richette P, Flipo R N, Patrikos D K
Université Paris Diderot, UFR Médicale, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Lariboisière, Fédération de Rhumatologie, Paris Cedex 10, France.
Eur Rev Med Pharmacol Sci. 2015 Feb;19(4):630-9.
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.
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.
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.
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.
为了增加在“现实生活”环境中痛风的流行病学和治疗知识，我们在两个欧洲国家，即法国和希腊进行了一项大型观察性分析（CACTUS）。
这是一项在法国和希腊进行的多中心、横断面观察性分析。该分析在实际临床场景中进行，由全科医生和风湿病学家招募患者纳入研究。治疗方法和药物处方完全由参与的医生自主决定。在单次纳入访视时记录了一些流行病学和临床特征。纳入访视后，通过每月访谈监测维持治疗的依从性。
共纳入3079例患者。高血压是最常见的合并症（68%），其次是高胆固醇血症（59%）和肥胖（48%）。血清尿酸（sUA）平均浓度为8.7mg/dl。几乎所有患者都接受了生活方式或饮食建议。纳入时，81.5%的患者正在接受降尿酸治疗。这些患者大多数曾接受过别嘌醇治疗；这种治疗因sUA水平未降至6mg/dl以下（47%）、症状未缓解（34%）或依从性差（23%）而中断。在纳入访视时，98%的患者被处方了降尿酸治疗：87%接受非布司他，12%仅接受别嘌醇。92%接受非布司他治疗的患者依从性良好或非常良好，而接受别嘌醇治疗的患者这一比例为82%。
CACTUS提供了痛风患者特征和痛风管理的概述。医疗保健提供者对患者的教育似乎是优化痛风管理的先决条件，痛风仍是一种管理不善的疾病。
