Dosage individualization proposed for anti-gout medications among the patients with gout.

<h4>Background</h4>The conventional one-size-fits-all approach has been criticized for almost all drugs used especially for chronic diseases, including gout. The present study was aimed to explore the need of individualization and optimization of the dose of anti-gout medications among g...

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Autores principales:	Binaya Sapkota, Suraj Chaudhary, Prakash Gurung, Anisha Humagain, Sujan Sapkota
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ae89989ff901427e98a23abe4d0704ed
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spelling	oai:doaj.org-article:ae89989ff901427e98a23abe4d0704ed2021-12-02T20:08:11ZDosage individualization proposed for anti-gout medications among the patients with gout.1932-620310.1371/journal.pone.0257082https://doaj.org/article/ae89989ff901427e98a23abe4d0704ed2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0257082https://doaj.org/toc/1932-6203<h4>Background</h4>The conventional one-size-fits-all approach has been criticized for almost all drugs used especially for chronic diseases, including gout. The present study was aimed to explore the need of individualization and optimization of the dose of anti-gout medications among gout patients.<h4>Methods</h4>Cross-sectional study was carried out among 384 randomly selected new gout patients visiting two gout treatment centers at Lalitpur Metropolitan City, Nepal and who were taking antigout medications. Patients not taking anti-gout medications and not showing willingness to participate were excluded. The eGFR was calculated with the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation (2009). Doses to be individualized were decided based on the Renal Drug Handbook and verified with the BNF 80. Data were analyzed via R 4.0.3 by applying the multinomial logistic regression to analyze statistical significance of risk with various predictors, and considering a p-value <0.05 statistically significant. Comorbidities were coded as per the ICD-11 coding and medicines were coded according to the WHO Guidelines for ATC classification and DDD assignment 2020.<h4>Results</h4>The high risk of progression to CKD increased in the age range 54-63 and ≥84 years by 17.77 and 43.02 times, respectively. Also, high risk increased by 29.83 and 20.2 times for the overweight and the obese respectively. Aceclofenac 100mg was prescribed for maximum patients (30.5%). Need of dose individualization was realized in 30 patients, with maximum (7) in case of etoricoxib 90mg. Various glucocorticoids were prescribed for 36.9% patients, out of whom 3.8%required dose individualization and 15.9% patients with xanthine oxidase inhibitors, out of whom 1.3% required dose individualization.<h4>Conclusion</h4>Thirty cases required dose individualization, which was although minimal but could have meaningful impact on the clinical success of the individual patient. Based on the recommendation on dose individualization, those patients could be optimized on their therapy on future follow ups.Binaya SapkotaSuraj ChaudharyPrakash GurungAnisha HumagainSujan SapkotaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 9, p e0257082 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Binaya Sapkota Suraj Chaudhary Prakash Gurung Anisha Humagain Sujan Sapkota Dosage individualization proposed for anti-gout medications among the patients with gout.
description	<h4>Background</h4>The conventional one-size-fits-all approach has been criticized for almost all drugs used especially for chronic diseases, including gout. The present study was aimed to explore the need of individualization and optimization of the dose of anti-gout medications among gout patients.<h4>Methods</h4>Cross-sectional study was carried out among 384 randomly selected new gout patients visiting two gout treatment centers at Lalitpur Metropolitan City, Nepal and who were taking antigout medications. Patients not taking anti-gout medications and not showing willingness to participate were excluded. The eGFR was calculated with the CKD Epidemiology Collaboration (CKD-EPI) creatinine equation (2009). Doses to be individualized were decided based on the Renal Drug Handbook and verified with the BNF 80. Data were analyzed via R 4.0.3 by applying the multinomial logistic regression to analyze statistical significance of risk with various predictors, and considering a p-value <0.05 statistically significant. Comorbidities were coded as per the ICD-11 coding and medicines were coded according to the WHO Guidelines for ATC classification and DDD assignment 2020.<h4>Results</h4>The high risk of progression to CKD increased in the age range 54-63 and ≥84 years by 17.77 and 43.02 times, respectively. Also, high risk increased by 29.83 and 20.2 times for the overweight and the obese respectively. Aceclofenac 100mg was prescribed for maximum patients (30.5%). Need of dose individualization was realized in 30 patients, with maximum (7) in case of etoricoxib 90mg. Various glucocorticoids were prescribed for 36.9% patients, out of whom 3.8%required dose individualization and 15.9% patients with xanthine oxidase inhibitors, out of whom 1.3% required dose individualization.<h4>Conclusion</h4>Thirty cases required dose individualization, which was although minimal but could have meaningful impact on the clinical success of the individual patient. Based on the recommendation on dose individualization, those patients could be optimized on their therapy on future follow ups.
format	article
author	Binaya Sapkota Suraj Chaudhary Prakash Gurung Anisha Humagain Sujan Sapkota
author_facet	Binaya Sapkota Suraj Chaudhary Prakash Gurung Anisha Humagain Sujan Sapkota
author_sort	Binaya Sapkota
title	Dosage individualization proposed for anti-gout medications among the patients with gout.
title_short	Dosage individualization proposed for anti-gout medications among the patients with gout.
title_full	Dosage individualization proposed for anti-gout medications among the patients with gout.
title_fullStr	Dosage individualization proposed for anti-gout medications among the patients with gout.
title_full_unstemmed	Dosage individualization proposed for anti-gout medications among the patients with gout.
title_sort	dosage individualization proposed for anti-gout medications among the patients with gout.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/ae89989ff901427e98a23abe4d0704ed
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Dosage individualization proposed for anti-gout medications among the patients with gout.

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