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  • Correspondence on ‘Ultrasound shows rapid reduction of crystal depositions during a treat-to-target approach in gout patients: 12-month results from the NOR-Gout study’

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Correspondence
Correspondence on ‘Ultrasound shows rapid reduction of crystal depositions during a treat-to-target approach in gout patients: 12-month results from the NOR-Gout study’
  1. Po-Cheng Hung1,
  2. Da-Hung Lin1,
  3. Amy Ker1,
  4. Chieh-Chun Yang1,
  5. Hung-Wan Chien2,
  6. James Cheng-Chung Wei3,4,5
  1. 1 School of Medicine, Chung Shan Medical University, Taichung, Taiwan
  2. 2 Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan
  3. 3 Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
  4. 4 Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan
  5. 5 Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
  1. Correspondence to Dr James Cheng-Chung Wei, Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung City 40201, Taiwan; jccwei{at}gmail.com

https://doi.org/10.1136/annrheumdis-2020-218846

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    With great interest, we read the article by Hammer et al reporting a treat-to-target (T2T) approach with urate-lowering treatment (ULT) resulted in significant reductions of crystal depositions via ultrasonic detection.1 We agree with the authors that the use of new semiquantitative scoring system may increase the sensitivity to minor changes in lesions in contrast to a binary scoring system. We would like, however, to highlight some key points.

    First and foremost, there is no control group in this study. Although patients with gout have rapid reduction of crystal depositions by a T2T approach, we cannot tell how much of this improvement is due to the effect of the treatment itself. Moreover, whether the operators and the participants are blind or not is unknown in the article. A double-blind, controlled study is essential for giving information on effectiveness. Next, there are medicines left out, and a subgroup analysis for different treatment is …

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    Footnotes

    • Contributors All other authors (PCH, DHL, AK, CCY, HWC and JCW) provided their input by contributing to the conceptualisation. PCH and HWC contributed to the editing of the manuscript. PCH and HWC contributed equally.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; internally peer reviewed.

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