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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Hilde Berner Hammer 1 2, Lars Karoliussen 3, Lene Terslev 4, Espen A Haavardsholm 3, Tore K Kvien 3 2, Till Uhlig 3 2

Main idea: The ultrasound scoring system for crystal depositions was sensitive to change and showed that a treat-to-target approach with urate-lowering treatment resulted in significant reductions of all the depositions, most extensively for double contour.

Abstract

Objectives: As ultrasound is sensitive for detecting crystal depositions in patients with gout, our objectives were to explore the main locations for depositions and the extent of dissolution of depositions during a treat-to-target approach with urate-lowering treatment (ULT) in patients with gout.

Methods: Patients with a recent flare of gout were consecutively included in this single-center study. All patients were assessed at baseline, 3, 6, and 12 months including bilateral ultrasound examinations of joints/tendons/entheses of hands, elbows, knees, ankles, and feet.

Results: 209 of the patients were evaluated with ultrasound at baseline (mean (SD) age 56.4 (13.8) years and disease duration 7.9 (7.7) years, 95.2% men). The serum urate levels decreased from baseline to 12 months. The first metatarsophalangeal joint was the most frequent location for all the elementary lesions and erosions.

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