Objectives The aim of this study was to investigate the radiographic changes in patients with gout in association with the control of serum uric acid level.
Methods A retrospective observational study in a single tertiary medical center was performed. Sixty one patients who had at least one erosive change on baseline radiography or tophus on physical examination were included. Follow up radiography was taken at least 5 years apart from baseline radiograph. The primary endpoint was the changes in the radiographic damage scores based on modified Sharp/van der Heijde (mSvH) score in association with the control of serum uric acid level during the study period. Patients were divided by three groups which consist of improved, no change, aggravated patients for subgroup analysis. The changes in the size of soft tissue density in radiograph were also measured.
Results The mean age was 55±13 years and 60 (98%) patients were male. Disease duration was 11±7 years and mean serum uric acid level was 8.8±1.9 mg/dL at baseline. Follow up duration between two radiographies was 10.8±3.6 years. All patients were receiving urate-lowering therapy. The change in the mean mSvH score between baseline and follow visit was not statistically significant (6.77 vs. 6.69, respectively). The number of patient in improved, no change, aggravated groups was 22, 14, and 25 and the mean baseline plain radiographic damage score was 12.1, 4.85, and 3.7 respectively. As expected, the change in damage scores was positively correlated to AUC of uric acid level (r=0.32, p=0.01). The patients with longer disease duration at baseline were more likely to have improvement in the follow up radiograph. (r=0.46, p=0.004). In subgroup analysis, only the baseline radiographic damage score was significantly different from each other. In improved group, the change of damage scores was negatively associated with disease duration at baseline (r=0.48, p=0.024).
Conclusions Our study demonstrated that radiographic damage in gout may be reversible to some extent and that the magnitude of improvement depends on the degree of serum uric acid control.
Disclosure of Interest None declared