Tags

Type your tag names separated by a space and hit enter

Evaluating appropriate use of prophylactic colchicine for gout flare prevention.
Arthritis Care Res (Hoboken) 2014; 66(8):1258-62AC

Abstract

OBJECTIVE

American College of Rheumatology and European League Against Rheumatism guidelines recommend colchicine to prevent gout flares in patients initiating and increasing uric acid–lowering therapy until serum uric acid is maintained at ≤6 mg/dl. We aimed to evaluate how well colchicine prescribing practices adhere to these guidelines and to examine factors associated with improved prescribing.

METHODS

Electronic medical records were reviewed for 126 patients with active colchicine prescriptions for prophylaxis of gout flares. Colchicine prescribing was defined as inappropriate if 1) no concurrent urate-lowering therapy was prescribed, 2) uric acid was not at goal and urate-lowering therapy had not been increased in the past 3 months, or 3) uric acid goals were met for >1 year and flares had resolved in the absence of tophi.

RESULTS

Colchicine use was considered inappropriate in 93 patients (73.8%). Thirty-four were prescribed no urate-lowering therapy, 50 were above the uric acid goal without urate-lowering therapy increase in the prior 3 months, and 9 were at the uric acid goal for >1 year without flares or tophi. Patients appropriately prescribed colchicine were younger and were more likely to have been seen by a rheumatologist. Allopurinol dose and allergy, uric acid level, and renal function were similar in the 2 groups.

CONCLUSION

We found a high prevalence of what we considered inappropriate prophylactic colchicine use, driven largely by failure to prescribe concurrent urate-lowering therapies or adequately increase these medications. Rheumatology consultation was associated with improved colchicine prescribing.

Authors+Show Affiliations

Hospital of the University of Pennsylvania, Philadelphia, PA 19104. michael.george@uphs.upenn.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24376081

Citation

George, Michael, et al. "Evaluating Appropriate Use of Prophylactic Colchicine for Gout Flare Prevention." Arthritis Care & Research, vol. 66, no. 8, 2014, pp. 1258-62.
George M, Pullman-Mooar S, Hussain F, et al. Evaluating appropriate use of prophylactic colchicine for gout flare prevention. Arthritis Care Res (Hoboken). 2014;66(8):1258-62.
George, M., Pullman-Mooar, S., Hussain, F., & Schumacher, H. R. (2014). Evaluating appropriate use of prophylactic colchicine for gout flare prevention. Arthritis Care & Research, 66(8), pp. 1258-62. doi:10.1002/acr.22275.
George M, et al. Evaluating Appropriate Use of Prophylactic Colchicine for Gout Flare Prevention. Arthritis Care Res (Hoboken). 2014;66(8):1258-62. PubMed PMID: 24376081.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Evaluating appropriate use of prophylactic colchicine for gout flare prevention. AU - George,Michael, AU - Pullman-Mooar,Sally, AU - Hussain,Fauzia, AU - Schumacher,H Ralph, PY - 2013/06/28/received PY - 2013/11/09/revised PY - 2013/12/17/accepted PY - 2013/12/31/entrez PY - 2014/1/1/pubmed PY - 2014/9/23/medline SP - 1258 EP - 62 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 66 IS - 8 N2 - OBJECTIVE: American College of Rheumatology and European League Against Rheumatism guidelines recommend colchicine to prevent gout flares in patients initiating and increasing uric acid–lowering therapy until serum uric acid is maintained at ≤6 mg/dl. We aimed to evaluate how well colchicine prescribing practices adhere to these guidelines and to examine factors associated with improved prescribing. METHODS: Electronic medical records were reviewed for 126 patients with active colchicine prescriptions for prophylaxis of gout flares. Colchicine prescribing was defined as inappropriate if 1) no concurrent urate-lowering therapy was prescribed, 2) uric acid was not at goal and urate-lowering therapy had not been increased in the past 3 months, or 3) uric acid goals were met for >1 year and flares had resolved in the absence of tophi. RESULTS: Colchicine use was considered inappropriate in 93 patients (73.8%). Thirty-four were prescribed no urate-lowering therapy, 50 were above the uric acid goal without urate-lowering therapy increase in the prior 3 months, and 9 were at the uric acid goal for >1 year without flares or tophi. Patients appropriately prescribed colchicine were younger and were more likely to have been seen by a rheumatologist. Allopurinol dose and allergy, uric acid level, and renal function were similar in the 2 groups. CONCLUSION: We found a high prevalence of what we considered inappropriate prophylactic colchicine use, driven largely by failure to prescribe concurrent urate-lowering therapies or adequately increase these medications. Rheumatology consultation was associated with improved colchicine prescribing. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/24376081/Evaluating_appropriate_use_of_prophylactic_colchicine_for_gout_flare_prevention_ L2 - https://doi.org/10.1002/acr.22275 DB - PRIME DP - Unbound Medicine ER -