The following is a summary of “Factors for achieving target serum uric acid levels after initiating urate-lowering therapy in patients with gout: results from the ULTRA registry,” published in the November 2023 issue of Rheumatology by Do et al.

Attaining optimal serum uric acid (SUA) levels is paramount in effectively managing gout. Guidelines recommend an SUA level of less than 6 mg/dL, but many gout patients struggle to achieve this target even with uric acid-lowering therapy (ULT). This study delved into identifying the clinical characteristics associated with successfully reaching target SUA levels among patients with gout.

Drawing upon data from the ULTRA registry, a comprehensive nationwide cohort established in September 2021, comprising gout patients initiating ULT, this investigation analyzed demographic, clinical, and laboratory information collected at baseline and the 6-month follow-up. Patients were categorized into two groups: those achieving the target SUA levels (below 6 mg/dL) and those who did not. The study enrolled 117 participants, with an average age of 56.1 years and a predominantly male population (88.0%). At the 6-month mark, 70.9% of participants (83 patients) reached the target SUA levels.

Key observations revealed that individuals achieving the target SUA levels exhibited notably higher adherence (≥80%) to ULT (97.6% vs. 76.5%; p < 0.01) compared to non-achievers. Conversely, non-achievers demonstrated a higher prevalence of family history associated with gout (32.4% vs. 10.8%; p < 0.01) and lower use of antihypertensive agents (38.2% vs. 59.0%; p = 0.03) in comparison to the target achievers.

Further multivariate regression analysis highlighted several factors associated with successfully attaining target SUA levels at the 6-month mark. These included robust adherence to ULT, the absence of a family history linked with gout, and the utilization of antihypertensive agents.

In essence, this study underscores the critical role of adherence to ULT, absence of familial gout history, and the use of antihypertensive medications as pivotal factors influencing the achievement of target SUA levels among patients with gout. These findings shed light on potential strategies to optimize gout management, emphasizing the significance of treatment adherence and identifying familial history and adjunctive medication use as influential components in achieving therapeutic goals.

Source: nature.com/articles/s41598-023-47790-6