Significance of the initiation time of urate-lowering therapy in gout patients: A retrospective research

Objective: To evaluate the efficacy and safety of the initiation time of urate-lowering treatments (ULT) in gout patients. Method: We retrospectively reviewed patients who were diagnosed with gout and were treated with ULT for at least 3 years. They were divided into two groups: group 1: 123 patients initiating ULT during an acute attack of gout; group 2: 457 patients prescribed ULT after an acute attack. Both demographic and clinical characteristics associated with gout were analyzed. Results: Comparing patients in group 1 versus group 2: the former exhibited a shorter duration of gout (6.3 +/- 2.1 vs. 8.9 +/- 3.3 years). At the baseline, there was no significant difference in mean serum urate (SU; 7.8 +/- 1.4 mg/dL vs. 7.9 +/- 1.9 mg/dL, respectively). SU target levels (<6.0 mg/dL) were achieved by 66.7 and 65.6% of the patients, respectively. The duration from initiation of ULT until the SU target was attained was lower in group 1 than in group 2. During the first 12 weeks, patients on ULT in group 1 had higher attack rates than those in group 2. The incidence of chronic kidney disease increased in percentage in group 1 was lower than in group 2. Conclusions: Our survey revealed that in patients experiencing acute gout, initiation of ULT decreased the time required to reach the target SU and the incidence of CKD, but the attack rate was greater in the first 12 weeks. (C) 2015 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.