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A survey on the management of gout in Malaysia
Author(s) -
YEAP Swan Sim,
GOH Emily M. L.,
GUN Suk Chyn
Publication year - 2009
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/j.1756-185x.2009.01431.x
Subject(s) - medicine , gout , allopurinol , hyperuricemia , colchicine , febuxostat , asymptomatic , rheumatology , physical therapy , uric acid
Aim: The aim of this study was to ascertain the management of gout by doctors in Malaysia. Methods: A cross‐sectional questionnaire survey was carried out among doctors attending rheumatology post‐graduate courses, where gout was not a lecture topic. Results: A total of 128 questionnaires were analyzed, of which the majority (67: 52.3%) were general practitioners. In the treatment of acute gout, 68.0% use non‐selective non‐steroidal anti‐inflammatory drugs (NSAIDs), 53.9% use selective COX‐2 inhibitors (coxibs), 66.4% use colchicine and 10.2% use allopurinol (ALLO). In the treatment of chronic gout, 36.7% use NSAIDs, 44.5% use coxibs, 19.5% use colchicine and 93% use ALLO. In both acute and chronic gout, corticosteroids (CS) are not used by over 90% of respondents. Fifty percent would stop ALLO during an acute attack. 95.3% do not start ALLO during an acute attack; 87.5% would start ALLO after the attack, with a median of 14 days afterwards. Once ALLO was started, 54.7% would continue indefinitely. Regarding target urate levels while on treatment, 10.9% would be satisfied with a high normal range, 21.9% middle of the range, 18.0% low normal range and 45.3% anywhere within the normal range. Fifteen percent would treat asymptomatic hyperuricemia. Conclusions: In Malaysia, anti‐inflammatory agents are most commonly used for the treatment of acute and chronic gout, with corticosteroid usage at a low level. However, there are areas of concern regarding the diagnosis of gout and the usage of ALLO which are not consistent with current guidelines.