Photo Credit: Mykola Churpita

The following is a summary of “Non-adherence to urate lowering therapy in gout after 5 years is related to poor outcomes—results from the NOR-Gout study,” published in the September 2024 issue of Rheumatology by Uhlig et al.

Patients with gout need long-term medication over time to achieve positive results. 

Researchers conducted a prospective study looking at self-reported adherence to urate-lowering therapy (ULT) 5 years after a treat-to-target intervention and how non-adherence related to initial demographic and disease factors. 

They included patients from the NOR-Gout study with recent gout flare and serum urate levels over 360  µmol/L. With a mean age of 56.2 (SD: 13.6) years with 94.5% males and 17.2% with tophi, participants attended tight-control visits for a year using a treat-to-target strategy. Adherence was assessed at 5 years using the Medication Adherence Report Scale (MARS-5) questionnaire. 

The results showed that at the 5-year mark, 95.1% of the 163 patients were using ULT. The MARS-5 adherence scores were high, with a median of 24 (IQR: 22-25). Patients in the lowest adherence quartile experienced more flares (33.3% vs.9.5%, P=0.004) and met the serum urate target less often (45.2% vs. 87.5%, P<0.001). Independent risk factors for non-adherence included lower age (OR 0.56, 95% CI: 0.39-0.79), non-European origin (OR 0.22, 95% CI: 0.06-0.80 ), lower SF-36 mental health scores (OR 0.94, 95% CI: 0.91-0.98), and less joint pain during the last flare (OR 0.73, 95% CI: 0.58-0.92).

Investigators concluded that patients showed high medication adherence after 5 years. However, non-adherence led to more flares and lower success in meeting urate targets, with younger age and non-European origin linked to non-adherence.

Source: academic.oup.com/rheumatology/advance-article/doi/10.1093/rheumatology/keae514/7760225