Otani Naoyoshi, Hamada Toshihiro, Kuwabara Masanari, Miyazaki Satoshi, Sato Yasuto, Nakayama Takeo, Ninomiya Haruaki, Konta Tsuneo, Hisatome Ichiro
Department of Cardiology, National Hospital Organization, Yonago Medical Center, Yonago, Japan.
Department of Cardiology, Dokkyo Medical University Nikko Medical Center, Nikko, Japan.
JMA J. 2025 Apr 28;8(2):470-478. doi: 10.31662/jmaj.2024-0399. Epub 2025 Mar 21.
The Japanese Society of Gout, Uric, and Nucleic Acid developed the Japanese Guideline for Management of Hyperuricemia and Gout (JGMHG) third edition, which contains seven clinical questions (CQs) and corresponding recommendations. Questionnaire surveys were conducted to clarify how recommendations regarding CQs influence decision-making in clinical practice.
The surveillances were conducted twice in 2018, just after the publication of JGMHG, and in 2020, 2 years later. The participants were members of the Japanese Society of Gout, Uric, and Nucleic Acid. While the 2018 surveys contained questionnaires on the recommendations of seven CQs as well as three questionnaires on the status of their use, the 2020 surveys contained those regarding their recommendations of seven CQs and seven questionnaires on the status of their use. The answers from 74 (response rate: 16%) and 61 (response rate: 14%) participants in 2018 and 2020, respectively, were analyzed using the chi-square test or Fisher's exact test.
The proportion of respondents in 2020 who agreed to reduce serum uric acid levels below 6 mg/dL in gout patients with tophi significantly increased compared to 2018. The agreement in 2020 with the long-term use of colchicine to reduce the recurrence of gout flares when initiating urate-lowering agents (ULAs) significantly increased compared to 2018. There were no significant differences between 2018 and 2020 in clinicians' attitudes toward support for the third JGMHG in daily practice, support for the use of recommendations toward each CQ, or support for finding themes for research or important clinical issues.
The third JGMHG plays an important role in popularizing recommendations for serum uric acid levels in patients with tophi and the long-term use of colchicine for prophylaxis of gout flares when initiating ULA, although it did not influence the distribution of responses regarding clinicians' attitudes toward its support.
日本痛风、尿酸与核酸协会制定了《日本高尿酸血症和痛风管理指南》（JGMHG）第三版，其中包含七个临床问题（CQs）及相应建议。开展问卷调查以明确关于CQs的建议如何影响临床实践中的决策。
监测分别在2018年（JGMHG发布后不久）和2020年（两年后）进行了两次。参与者为日本痛风、尿酸与核酸协会的成员。2018年的调查包含关于七个CQs建议的问卷以及三份关于其使用情况的问卷，2020年的调查包含关于七个CQs建议的问卷以及七份关于其使用情况的问卷。分别对2018年的74名参与者（回复率：16%）和2020年的61名参与者（回复率：14%）的答案进行卡方检验或Fisher精确检验分析。
与2018年相比，2020年同意将有痛风石的痛风患者血清尿酸水平降至6mg/dL以下的受访者比例显著增加。与2018年相比，2020年对于在开始使用降尿酸药物（ULAs）时长期使用秋水仙碱以减少痛风发作复发的认同度显著增加。2018年和2020年临床医生在日常实践中对支持第三版JGMHG、支持对每个CQ使用建议或支持寻找研究主题或重要临床问题方面的态度无显著差异。
第三版JGMHG在推广针对有痛风石患者的血清尿酸水平建议以及在开始使用ULAs时长期使用秋水仙碱预防痛风发作方面发挥了重要作用，尽管它并未影响临床医生对其支持态度的回复分布情况。
