PT  - JOURNAL ARTICLE
AU  - Naomi Schlesinger
AU  - Dirk F Moore
AU  - Jennifer D Sun
AU  - H Ralph Schumacher, Jr
TI  - A survey of current evaluation and treatment of gout.
DP  - 2006 Oct 01
TA  - The Journal of Rheumatology
PG  - 2050--2052
VI  - 33
IP  - 10
4099  - http://www.jrheum.org/content/33/10/2050.short
4100  - http://www.jrheum.org/content/33/10/2050.full
SO  - J Rheumatol2006 Oct 01; 33
AB  - OBJECTIVE: To record diagnostic and treatment approaches to gouty arthritis among US rheumatologists. METHODS: Questionnaires were faxed to 2500 US rheumatologists. RESULTS: Responses were received from 518 rheumatologists. Respondents reported performing crystal analysis 80% of the time for new suspected gout; 64% use combination therapy for acute gout; nonsteroidal antiinflammatory drugs alone are used in only 27%. Urate-lowering drugs (ULD) are given to most patients. ULD treatment is given occasionally to patients with asymptomatic hyperuricemia (4%) but most frequently to patients after 2 (59%) or 3 (34%) attacks. ULD are given with the aim of achieving a serum urate (SU) level of 6 mg/dl. CONCLUSION: Combination antiinflammatory agents are used frequently for acute gout despite absence of evidence in the literature to support this practice. There seems to be consensus regarding the necessity of lowering SU to < 6 mg/dl. Approaches vary widely, supporting the need for longterm prospective, placebo controlled studies to provide more evidence-based guidance.