Department of Rheumatology B, El Ayachi Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.
Laboratory of Physiology, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco.
Rheumatol Int. 2020 Sep;40(9):1399-1408. doi: 10.1007/s00296-020-04599-0. Epub 2020 May 23.
To assess the modalities and current practices in gout management reported by Moroccan rheumatologists. We performed a cross-sectional online survey using a questionnaire e-mailed to 360 rheumatologists included 30 multiple-choice questions. 105 rheumatologists responded to the survey with 29% of response rate. The number of gout patients seen per month was five (3-9); they were referred in 58.7% by a general practitioner. The clinical presentation of gout patients was dominated by gout crisis in 71%, and the association gout crisis and gouty arthropathy accounted for 19% of severe forms. 40% of rheumatologists apply the 2015ACR/EULAR classification criteria. Obesity accounted for 85.7% of the associated comorbidities. The most commonly prescribed Urate-lowering therapy (ULT) was allopurinol in 81.3% (± 12). 48% of rheumatologists reported starting allopurinol at 200 mg daily and associated it with colchicine during the first 6 months by 33.3%. The determination of uric acid levels was monitoring in 76.2% every 3 months. Administration of ULT to asymptomatic hyperuricemia was found in 69.5% when patients had renal complications, while only 14.3% recommended dietary and lifestyle measures. The median duration for therapeutic education was 15 min (10, 20). In 96.2%, the education of the patient was done orally. 93.3% of rheumatologists inform their patients on how to manage a gout attack, and 96.2% on the measures of hygiene and diet has adopted. Our survey gives an insight into the elements that should be improved in the management of gout by the Moroccan rheumatologists. It highlights the need to standardize the management of gout, hence the importance of developing Moroccan recommendations on gout.
评估摩洛哥风湿病学家报告的痛风管理模式和当前实践。我们使用电子邮件向 360 名风湿病学家发送了一份问卷,进行了一项横断面在线调查,其中包含 30 个多项选择题。105 名风湿病学家对调查做出了回应,回应率为 29%。每月看诊的痛风患者数量为五人(3-9 人);他们中有 58.7%是由全科医生转诊而来。痛风患者的临床表现以痛风发作为主,占 71%,痛风发作和痛风性关节炎的合并占严重形式的 19%。40%的风湿病学家采用 2015 年 ACR/EULAR 分类标准。肥胖占相关合并症的 85.7%。最常开的降尿酸治疗(ULT)是别嘌醇,占 81.3%(±12)。48%的风湿病学家报告开始每天服用 200mg 别嘌醇,并在头 6 个月内按 33.3%的比例联合使用秋水仙碱。76.2%的风湿病学家每 3 个月监测一次尿酸水平。当患者有肾脏并发症时,有 69.5%的无症状高尿酸血症患者接受 ULT 治疗,而只有 14.3%的人建议采取饮食和生活方式措施。治疗教育的平均持续时间为 15 分钟(10 分钟,20 分钟)。96.2%的情况下,通过口头向患者进行教育。93.3%的风湿病学家告知患者如何应对痛风发作,96.2%的风湿病学家告知患者如何采取卫生和饮食措施。我们的调查深入了解了摩洛哥风湿病学家在痛风管理方面需要改进的方面。它强调了规范痛风管理的必要性,因此制定摩洛哥痛风建议的重要性。