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AB0633 Treating to target ultrasound findings only is equivalent to urate-lowering therapy in patients with chronic gout.
  1. K. Kume1,
  2. K. Amano1,
  3. S. Yamada1,
  4. T. Kanazawa1,
  5. H. Ohta1,
  6. K. Hatta1,2,
  7. H. komori3
  1. 1Rheumatology, HIROSHIMA CLINIC, hiroshima
  2. 2Rheuamatology, Hatta Clinic, Kure
  3. 3internal medicine, HIROSHIMA CLINIC, hiroshima, Japan

Abstract

Background Urate-lowering therapy (uric acid<6.0 mg/dL) (ULT) is recommended in chronic gout. In these days ultrasound (US) is very improved, and useful for diagnosis and treatment.

Objectives To comparerecurrent gout attacks in chronic gout treated by US findings normalization strategy or ULT strategy.

Methods We designed an open label, randomized controlled trial. We screened 74 chronic gout (uric acid>7.0 mg /ld., and double contour sign of US findings in any joint) for inclusion. 63 gout patients were randomly allocated either US strategy group (US group) or ULT group(C group). In both strategies febuxostat is used. US strategy is performed US by 4 weeks. Double contour sign or urate crystals were evaluated; febuxostat is intensified to dissolve it. ULT strategy is performed blood examination by 4 weeks. Febuxostat is intensified to target uric acid <6.0mg/dL. Primary outcome measure were proportion of no recurrent attack within 52 weeks. Analysis was by intention-to-treat.

Results The characteristics of each group at baseline were not significantly different. There was no significant difference in the proportion of no recurrent attack within 52 weeks between the US strategy (87.6%) and ULT strategy (83.4%) groups. There was no significant difference in the occurrence of adverse events (AEs) between the US strategy and ULT strategy groups.

Conclusions In chronic gout, if the patients were treated by febuxostat, US without blood examination might be equivalent to uric acid in blood.

  1. A systematic review of ultrasonography in gout and asymptomatic hyperuricaemia. Chowalloor PV, et al. Ann Rheum Dis. 2013 Jan 3. [Epub ahead of print]2. EULAR evidence based recommendations for gout. Part II:Management. Report of a task force of the EULAR Standing Committee For International Clinical Studies Including Therapeutics (ESCISIT). Zhang W, et al. Ann Rheum Dis. 2006 Oct;65(10):1312-24. Epub 2006 May 17.3. Efficacy and Tolerability of Febuxostat in Hyperuricemic Patients With or Without Gout: A Systematic Review and Meta-Analysis. Ye P, et al. Clin Ther. 2013 Jan 15. doi:pii: S0149-2918(12)00723-0. 10.1016/j.clinthera.2012.12.011.

Disclosure of Interest: None Declared

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