Optimal range of serum urate concentrations to minimize risk of gouty attacks during anti-hyperuricemic treatment.
To find an optimal range of urate concentrations wherein the risk of attacks during the initial 6 months of treatment is minimized, data from 350 gouty patients treated with anti-hyperuricemic drugs were retrospectively analyzed. We determined the optimal range of urate concentrations to be 4.6-6.6 mg/dl. If urate concentrations were within this range, the risk ratio of an attack as opposed to outside of the range was 0.705 (95% confidence interval, 0.629-0.791). The increase (or decrease) in urate concentration in one month associated with minimal risk of gouty attacks was also determined. The lowest risk ratio of attack (0.451) occurred at a range of -0.1 to 0.6 mg/dl/month increase in urate concentrations (95% confidence interval, 0.310-0.655). In conclusion, we propose that urate concentrations during the initial 6 months of anti-hyperuricemic therapy should be maintained within a range of 4.6-6.6 mg/dl, and reduction in the urate concentrations during treatment should be as slow as possible.
Yamanaka
H
H
Institute of Rheumatology, Tokyo Women's Medical College, Japan.
Togashi
R
R
Hakoda
M
M
Terai
C
C
Kashiwazaki
S
S
Dan
T
T
Kamatani
N
N
D015415:Biomarkers / Q000097:blood; D016001:Confidence Intervals; D016903:Drug Monitoring / Q000379:methods; D006073:Gout / Q000453:epidemiology / Q000517:prevention & control*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D011686:Purine-Pyrimidine Metabolism, Inborn Errors / Q000097:blood* / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood*
D015415:Biomarkers; D006074:Gout Suppressants; D014527:Uric Acid