Determinants of the clinical outcomes of gout during the first year of urate-lowering therapy.
Clinical benefit early in urate-lowering treatment of gout is difficult to document. We examined data from 1,832 gouty subjects treated with either urate-lowering agents or placebo to identify determinants of gout flare incidence and tophus size during year 1 of treatment. Reductions from pretreatment serum urate levels influenced flare frequency and tophus size, but the effect of urate level on flare incidence was biphasic. Lower urate levels were associated with higher flare incidence early in treatment but lower incidence by one year. The complex relationship between urate-lowering and clinical outcome early in treatment has implications for both clinical and investigative approaches to urate-lowering management.
Becker
Michael A
MA
Rheumatology Section, Department of Medicine, University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA. mbecker@medicine.bsd.uchicago.edu
MacDonald
Patricia A
PA
Hunt
Barbara J
BJ
Lademacher
Christopher
C
Joseph-Ridge
Nancy
N
D000493:Allopurinol / Q000627:therapeutic use; D000069465:Febuxostat; D006073:Gout / Q000188:drug therapy / Q000628:therapy*; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D016014:Linear Models; D015999:Multivariate Analysis; D016017:Odds Ratio; D013844:Thiazoles / Q000627:therapeutic use; D013997:Time Factors; D016896:Treatment Outcome
D006074:Gout Suppressants; D013844:Thiazoles; D000069465:Febuxostat; D000493:Allopurinol