Dalbeth N, Billington K, Doyle A, et al. - Through an imaging study of a 2-year randomized clinical trial, researchers investigated whether allopurinol dose escalation to achieve serum urate (SU) target could affect bone erosion or monosodium urate (MSU) crystal deposition, as measured by dual-energy computed tomography (DECT) in 87 individuals with gout. The progress in the CT erosion score was greater in the control group vs dose-escalation group in year 2. Alterations in plain radiography erosion or narrowing scores did not vary among groups. In both groups, reductions in DECT urate volume were noted. Individuals in the control group who had a SU level of < 0.36 mmoles/liter and individuals in the dose-escalation group had decreased DECT urate volume, whereas a decline in DECT urate volume was not noted in control group individuals with a SU level of ≥ 0.36 mmoles/liter, in year 2. Hence, it was evident that long-term urate-lowering therapy using a treat-to-SU-target strategy could affect structural damage and decrease urate crystal deposition in gout.