Withdrawal of longterm antihyperuricemic therapy in tophaceous gout.
OBJECTIVE
To determine the effect of withdrawal of antihyperuricemic therapy on the recurrence of tophi and acute arthritis.


METHODS
We performed a retrospective investigation of 21 patients with tophaceous gout who stopped therapy because they had no arthritis for years, and on examination tophi had disappeared.


RESULTS
Nine patients (43%) had a recurrence of tophi after an average period of 39.6 months (range 4-107 months). Seventeen patients (81%) had attacks of acute arthritis, 6 patients within 6 months. During a mean period of drug discontinuation of 37.6 months no increase in serum creatinine or deterioration in joint function was observed.


CONCLUSIONS
Based on our data we conclude that intermittent usage of antihyperuricemic drugs will, after a variable period, result in the frequent recurrence of acute arthritis and tophi.
van Lieshout-Zuidema
M F
MF
Department of Rheumatology, University Hospital, Leiden, The Netherlands.
Breedveld
F C
FC
D000328:Adult; D000493:Allopurinol / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D006073:Gout / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors; D014527:Uric Acid / Q000097:blood* / Q000378:metabolism* / Q000652:urine; D014528:Uricosuric Agents / Q000008:administration & dosage* / Q000378:metabolism / Q000627:therapeutic use
D014528:Uricosuric Agents; D014527:Uric Acid; D000493:Allopurinol