Gout is a common inflammatory arthritis with appropriate treatments and a well-understood disease mechanism, yet many patients are not receiving appropriate therapy; therefore, a disease that is curable is only seldom cured. The recent guidelines issued by the ACR for the management of this disease highlight the need for early treatment, including the treatment of acute gouty attacks within 24 hours, reducing serum urate levels to below 6 mg/dL, and prescribing appropriate pharmacotherapy with currently available medications that can control serum urate levels in these patients.
In addition to the guidelines that are discussed in this issue of Value-Based Care in Rheumatology (page 1), another article also mentioned in this issue (page 6) highlights the current reality that only approximately 50% of physicians manage patients with gout according to the recent ACR recommendations, leaving much room for improvement to change the face of this disease by adhering to evidence-based practice guidelines.
Discussing the question of why a curable disease is so seldom cured, Michael Doherty, MD, and colleagues note in a recent article that “Doctors often focus on managing acute attacks rather than viewing gout as a chronic progressive crystal deposition disease. Urate-lowering treatment is underprescribed and often underdosed. Appropriate education of patients and doctors…may help to overcome these barriers and improve management of this easily diagnosed and curable form of potentially severe arthritis.” Ann Rheum Dis. 2012;71:1765