Latourte A, et al. – In this cross–sectional study, the specialists explored the factors associated with poor control of serum urate levels (sUA) in gouty patients receiving urate–lowering therapy (ULT). Investigations revealed that the main factors associated with a poor response to ULT were dyslipidaemia, abdominal obesity and alcohol consumption. Knowledge of these factors might help physicians to identify cases of gout that were less likely to achieve target urate level.

Methods

• This study selected adults with gout in primary care who received ULT.
• On univariate and multivariate analyses, demographics, gout history, comorbidities, lifestyle, clinical factors, concomitant treatments and laboratory data were compared in well–controlled gout (sUA ≤ 6 mg/dL) versus poorly–controlled gout (sUA > 6 mg/dL).

Results

• Out of 1995 patients receiving ULT, only 445 (22.3%) had reached the target of 6 mg/dL sUA.
• Such patients had a lower rate of gout flares within the previous year than patients without the target (1.7±1.4 vs. 2.1±1.4, p < 0.0001).
• The main factors associated with poor sUA level control in multivariate analysis were low high–density lipoprotein–cholesterol level (adjusted odds ratio 0.5, 95% confidence interval 0.26 to 0.96; p=0.04), high total cholesterol level (1.83, 1.29 to 2.60; p=0.0007), increased waist circumference (1.55, 1.11 to 2.13; p=0.008) and alcohol consumption (1.52, 1.15 to 2.00; p=0.003).