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Gout treatment: survey of Brazilian rheumatology residents

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Abstract

To assess the current practices in gout management among Brazilian rheumatology residents. We performed a cross-sectional online survey among all the rheumatology residents and those rheumatologists who had just completed their training (post-residency (PR)) regarding their approach to gout management. Results were compared with the 2012 American College of Rheumatology (ACR) gout guidelines and with the responses of a previous survey with a representative sample of practicing Brazilian rheumatologists (RHE). We received 224 responses (83%) from 271 subjects. Among all respondents, the first-choice treatment for gout flares was the combination of a nonsteroidal anti-inflammatory drug + colchicine for otherwise healthy patients. A target serum urate <6 mg/dL for patients without tophi was reported by >75%. Less than 70% reported starting allopurinol at low doses (≤100 mg/day) for patients with normal renal function and <50% reported maintaining urate-lowering therapy indefinitely for patients without tophi. Among residents and PR, the residency stage was the main predictor of concordance with the ACR guidelines, with PR achieving the greatest rates. Reported practices were commonly concordant with the 2012 ACR gout guidelines, especially among PR. However, some important aspects of gout management need improvement. These results will guide the development of a physician education program to improve the management of gout patients in Brazil.

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Acknowledgements

We are grateful to the Brazilian Society for Rheumatology and to the Rheumatology Residency Programs for providing us with the necessary data, to the Gout Committee members for their support, and to the rheumatologists whose participation made this survey possible.

Author information

Authors and Affiliations

  1. Division of Rheumatology, Internal Medicine Department, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil

    Rodrigo Balbino Chaves Amorim, Ana Beatriz Vargas-Santos, Leticia Rocha Pereira & Geraldo da Rocha Castelar-Pinheiro

  2. Epidemiology Department, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil

    Evandro Silva Freire Coutinho

Authors
  1. Rodrigo Balbino Chaves Amorim
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  2. Ana Beatriz Vargas-Santos
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  3. Leticia Rocha Pereira
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  4. Evandro Silva Freire Coutinho
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  5. Geraldo da Rocha Castelar-Pinheiro
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Corresponding author

Correspondence to Rodrigo Balbino Chaves Amorim.

Ethics declarations

This study was approved by the local Institutional Review Board of Hospital Universitário Pedro Ernesto under the number 31947614.8.0000.5259. The manuscript does not contain clinical studies or patient data.

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Amorim, R.B.C., Vargas-Santos, A.B., Pereira, L.R. et al. Gout treatment: survey of Brazilian rheumatology residents. Clin Rheumatol 36, 1179–1188 (2017). https://doi.org/10.1007/s10067-017-3543-7

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  • DOI: https://doi.org/10.1007/s10067-017-3543-7

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