{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T13:09:52Z","timestamp":1777727392164,"version":"3.51.4"},"reference-count":24,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2021,5,1]],"date-time":"2021-05-01T00:00:00Z","timestamp":1619827200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81901667"],"award-info":[{"award-number":["81901667"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Capital Medical Development Research Fund","award":["2018-1-4012"],"award-info":[{"award-number":["2018-1-4012"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Int Med Res"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore the understanding of refractory gout in Chinese rheumatologists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted an anonymous survey of rheumatologists attending an annual national academic conference on rheumatism.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 910 rheumatologists who completed the questionnaire, 751 (82.5%) had received relevant continuing medical education (CME). Of these, 140 (18.6%) rheumatologists did not select xanthine oxidase inhibitors as the first treatment for patients with chronic tophaceous gout. Of all respondents, 113 (12.4%), 251 (27.6%) and 324 (35.6%) prescribed incorrect maximum doses of allopurinol, febuxostat and benzbromarone, respectively; this tendency was more pronounced in the non-CME group. Most rheumatologists agreed that complications and comorbidities increased the difficulty of gout management and considered the term refractory gout to describe those cases with uncontrolled symptoms, unmet treatment targets or non-shrinkage of tophi after standardized drug treatment. Moreover, 62.8% (472\/751) of specialists considered that a diagnosis of refractory gout was appropriate for patients whose lifestyle and compliance failed to improve despite adequate education and regular urate-lowering therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Incorrect and inadequate drug therapy may contribute to some cases of refractory gout, especially in physicians without CME. An emphasis on non-drug therapy and the management of comorbidities and complications may reduce cases of refractory gout.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03000605211016149","type":"journal-article","created":{"date-parts":[[2021,5,29]],"date-time":"2021-05-29T15:52:33Z","timestamp":1622303553000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Rheumatologists\u2019 understanding of refractory gout: a questionnaire survey in China"],"prefix":"10.1177","volume":"49","author":[{"given":"Xinxin","family":"Han","sequence":"first","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yue","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaotian","family":"Chu","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yingdong","family":"Han","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Di","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6426-7586","authenticated-orcid":false,"given":"Xuejun","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of General Internal Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, P.R. China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2021,5,26]]},"reference":[{"key":"bibr1-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)00346-9"},{"key":"bibr2-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2015.91"},{"key":"bibr3-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/762820"},{"key":"bibr4-03000605211016149","doi-asserted-by":"publisher","DOI":"10.3810\/psm.2011.11.1946"},{"key":"bibr5-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket158"},{"key":"bibr6-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1002\/acr.21772"},{"key":"bibr7-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215315"},{"key":"bibr8-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13266"},{"key":"bibr9-03000605211016149","first-page":"892","volume":"55","author":"Chinese Rheumatology Association","year":"2016","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"bibr10-03000605211016149","first-page":"235","volume":"56","author":"Multi-Disciplinary Expert Task Force on Hyperuricemia and Its Related Diseases","year":"2017","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"bibr11-03000605211016149","first-page":"305","volume":"3","author":"Yu TF.","year":"1976","journal-title":"J Rheumatol"},{"key":"bibr12-03000605211016149","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp160961"},{"key":"bibr13-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1177\/2042098617727714"},{"key":"bibr14-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2017.1349099"},{"key":"bibr15-03000605211016149","first-page":"2041","volume":"33","author":"Fang W","year":"2006","journal-title":"J Rheumatol"},{"key":"bibr16-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22741"},{"key":"bibr17-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e3282f4eff5"},{"key":"bibr18-03000605211016149","doi-asserted-by":"crossref","first-page":"e51","DOI":"10.1055\/a-0755-1341","volume":"144","author":"Triantafyllias K","year":"2019","journal-title":"Dtsch Med Wochenschr"},{"key":"bibr19-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32158-5"},{"key":"bibr20-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2017.09.007"},{"key":"bibr21-03000605211016149","first-page":"2186","volume":"95","author":"Gao H","year":"2015","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"bibr22-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1007\/s00391-017-1197-3"},{"key":"bibr23-03000605211016149","first-page":"28","volume":"59","author":"Ivanova MM","year":"1987","journal-title":"Ter Arkh"},{"key":"bibr24-03000605211016149","doi-asserted-by":"publisher","DOI":"10.1177\/0300060518800114"}],"container-title":["Journal of International Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605211016149","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03000605211016149","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03000605211016149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T10:49:18Z","timestamp":1777459758000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03000605211016149"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1177\/03000605211016149"],"URL":"https:\/\/doi.org\/10.1177\/03000605211016149","relation":{},"ISSN":["0300-0605","1473-2300"],"issn-type":[{"value":"0300-0605","type":"print"},{"value":"1473-2300","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]},"article-number":"03000605211016149"}}