Adherence and Treat‐to‐Target Benchmarks in Older Adults With Gout Initiating Urate‐Lowering Therapy in Ontario, Canada: A Population‐Based Study
Authors' conclusion
Only 52.3% of patients achieved an optimal SUA level within 1 year of ULT initiation. ULT adherence was suboptimal, although improving over time. ULT adherence and higher allopurinol starting doses had the strongest associations of achieving a target SUA level.
Study context
- Population
- Patients with gout aged ≥66 years newly dispensed urate-lowering therapy (ULT), Ontario, Canada, 2010–201930,057 with ≥1 serum uric acid (SUA) test
- Participants
- 44,438 patients
- Outcome
- Successful T2T: SUA <360 μmol/L (6 mg/dL) within 12 months after ULT dispensation
- Follow-up
- 12 months
Methodological detailspopulation-based, multilevel logistic regression clustered by ULT prescriber
- Population-based
- Multilevel logistic regression clustered by ULT prescriber
Main finding
As reported in the abstract
Reached SUA target within 12 months
Overall reached SUA target
52.3%
Reached target in 2010
45.2%
Reached target in 2019 (P < 0.0001)
61.2%
Observational data: associations, not effects.
Further findings
Factors associated with achieving treatment-to-target (T2T)
| OR (95% CI) | ||
|---|---|---|
| Febuxostat treatmentOnly dispensed in 88 patients | 11.40 (5.10–25.43) | |
| ULT adherence | 5.17 (4.89–5.47) | |
| Allopurinol starting doses >50 mg | 2.53 (2.14–2.99) | |
| Colchicine/oral GC co-prescription | 1.24 (1.14–1.34) | |
| 0.050.21520Odds ratio (log scale) |
ULT adherence
- ULT adherence overall; improved annually
- 55.3%
Factors associated with achieving T2T
- ULT prescription from a rheumatologist associated with achieving T2T
Original publication
Adherence and Treat‐to‐Target Benchmarks in Older Adults With Gout Initiating Urate‐Lowering Therapy in Ontario, Canada: A Population‐Based Study. Arthritis Care Res (Hoboken). Published 23 June 2024. doi:10.
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