Send to

Choose Destination
Swiss Med Wkly. 2019 Sep 2;149:w20121. doi: 10.4414/smw.2019.20121. eCollection 2019 Aug 26.

The target uric acid level in multimorbid patients with gout is difficult to achieve: data from a longitudinal Swiss single-centre cohort.

Author information

Department of Rheumatology, University Hospital Basel, Switzerland / Department of Rheumatology, Schmerzklinik Basel, Switzerland.
Medical Outpatient Clinic, University Hospital Basel, Switzerland / Department of Biomedicine, Translational Immunology Laboratory, University Hospital Basel, Switzerland.
Faculty of Medicine, University of Basel, Switzerland.
Department of Rheumatology, University Hospital Basel, Switzerland.
Service de Rhumatologie, Département de l'appareil locomoteur, CHUV, Lausanne, Switzerland.



To characterise adherence and treat-to-target (T2T) strategy in gout patients within a Swiss tertiary hospital.


Consecutive presenting patients with proven gout were prospectively included in this cohort. Symptoms, comorbidities, medication and laboratory values were assessed (during hospitalisation and at planned 3- and 12-month follow-up assessments).


116 patients (98 men) with a mean age of 67 (range 23–94 years) were included, 74% of whom had active arthritis. Comorbidities were frequent: hypertension, renal impairment, and obesity were present in 72, 55 and 35% of patients, respectively. Thirty-five percent of patients received urate-lowering treatment at inclusion. Only 62 and 50% attended the 3- and 12-month follow-up. The target serum uric acid level of <360 μmol/l was achieved in 22 and 57% of patients by the 3- and 12-month follow-up visits, respectively. Patients followed up by rheumatologists reached the target serum uric acid at follow-up more often than those that were not (p = 0.033). Median daily allopurinol dose at 12-month follow-up was 300 mg in those achieving T2T and 100 mg in the others (p = 0.033). Flares occurred during the first 3 months in 52% and during the subsequent 9 months in 47% of patients.


Only half of patients attended the planned follow-up visits, indicating low awareness for gout. Of those attending follow-up, only approximately 50% had achieved the serum urate target at 12 months. Although new treatments are available, care for gout patients remains insufficient, notably in difficult-to-treat multimorbid patient subsets as described in this cohort.

Free full text

Supplemental Content

Full text links

Icon for EMH Swiss Medical Publishers Ltd.
Loading ...
Support Center