慢性痛风：有效管理的障碍。

Chronic gout: Barriers to effective management.

机构信息

BAppSci, MD, Junior Medical Officer, Tweed Hospital, Tweed Heads, NSW.

MBBS, FRACP, MBioethics, Associate Professor of Medicine, Sydney Medical Program; Associate Dean and Head, School of Rural Health, University of Sydney, NSW.

出版信息

Aust J Gen Pract. 2018 Jun;47(6):351-356. doi: 10.31128/AJGP-11-17-4384.

DOI:10.31128/AJGP-11-17-4384

PMID:29966174

Abstract

BACKGROUND

Gout is one of the most common inflammatory arthropathies, and the pathogenesis is well understood. In Australia, most patients with chronic tophaceous gout (CTG) are treated by general practitioners (GPs). Urate-lowering therapy, if adhered to continuously, can suppress the disease, reduce the likelihood of flares and prevent long-term complications such as disfiguring tophi and joint damage. Many rheumatology societies recommend a treat-to-target (T2T) approach, lowering serum urate to 0.35 mmol/L or below with urate lowering therapy.

OBJECTIVE

The aim of this article is to discuss inconsistencies in treatment guidelines, identify patient and physician barriers to optimal gout care, explain why a T2T approach is appropriate and make a series of recommendations that are practical for GPs.

DISCUSSION

Despite an in-depth understanding of this controllable disease and the availability of simple, safe treatments, chronic gout remains poorly managed. The development of Australian gout guidelines that are easily implemented by GPs is vital and overdue.

摘要

背景

痛风是最常见的炎性关节病之一，其发病机制已被充分了解。在澳大利亚，大多数慢性痛风石性痛风（CTG）患者由全科医生（GP）治疗。如果持续坚持降尿酸治疗，可以抑制疾病，减少发作的可能性，并预防长期并发症，如破坏性痛风石和关节损伤。许多风湿病学会推荐采用达标治疗（T2T）方法，即通过降尿酸治疗将血清尿酸降低至 0.35mmol/L 或以下。