DIVERSITY OF OPINIONS ON THE MANAGEMENT OF GOUT IN FRANCE - A SURVEY OF 750 RHEUMATOLOGISTS

Gout is a common disease. Although effective treatments are available for gout, there is some disagreement as to how they should be used. To study prescription patterns in gout, we conducted a questionnaire sur vey among 2520 rheumatologists. Seven hundred and fifty completed ques tionnaires were returned over a two-month period. Among respondents, 3 5.4% worked in a private office, 21% in a hospital and 43.6% in both. The most widely prescribed treatments in acute gout attack were colchi cine alone (63%), colchicine with a nonsteroidal antiinflammatory drug (NSAID) (31.7%) and NSAID alone (5.2%), with significant variations a ccording to the type of practice. Mean duration of treatment in acute gout was 18+/-16.8 days (range, 3-180 days). Mean time interval betwee n the attack and initiation of therapy with a xanthine oxidase inhibit or was 21.6+/-17.2 days (range 0-180); here also, significant variatio ns were seen according to the type of practice. Concomitant symptomati c therapy was prescribed in 97.3% of cases, for a mean duration of 54/-55.4 days (range 2-365). Thirty per cent of responders never prescri bed uricosuric agents. The estimated rate of occurrence of treatment-i nduced attacks increased with the reported interval between the attack and initiation of urate-lowering therapy. Our data demonstrate that F rench rheumatologists have widely diverging views on how to treat gout . Whether a waiting period is needed between an acute attack and initi ation of urate-lowering therapy, and how long this period should be, a re unsettled issues that deserve to be studied.