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Abstract Number: 182

Effect of Urate-Lowering Therapy on Radiographic Changes in Gout Patients

Seulkee Lee1, Inyoung Kim1, Hyemin Jeong1, Jiwon Hwang1, Hyungjin Kim1, Jaejoon Lee2, Hoon-Suk Cha1 and Eun-mi Koh2, 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea, 2Division of Rheumatology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Gout and tophaceous gout

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Session Information

Title: Metabolic and Crystal Arthropathies: Clinical Aspects

Session Type: Abstract Submissions (ACR)

Background/Purpose  The aim of this study was to investigate the radiographic changes in patients with gout in association with the control of serum uric acid level.

Methods  A retrospective observational study in a single tertiary medical center was performed. Sixty one patients who had at least one erosive change on baseline radiography or tophus on physical examination were included. Follow up radiography was taken at least 5 years apart from baseline radiograph. The primary endpoint was the changes in the radiographic damage scores based on modified Sharp/van der Heijde (mSvH) score in association with the control of serum uric acid level during the study period. Patients were divided by three groups which consist of improved, no change, aggravated patients for subgroup analysis. The changes in the size of soft tissue density in radiograph were also measured.

Results  The mean age was 55±13 years and 60 (98%) patients were male. Disease duration was 11±7 years and mean serum uric acid level was 8.8±1.9 mg/dL at baseline. Follow up duration between two radiographies was 10.8±3.6 years. All patients were receiving urate-lowering therapy. The change in the mean mSvH score between baseline and follow visit was not statistically significant (6.77 vs. 6.69, respectively). The patient number of improved, no change, aggravated groups was 22, 14, and 25 and the baseline plain radiographic damage score was 12.1, 4.85, and 3.7 respectively. As expected, the change in damage scores was positively correlated to AUC of uric acid level (r = 0.32, p=0.01). The patients with longer disease duration at baseline were more likely to have improvement in the follow up radiograph. (r = 0.46, p=0.004). In subgroup analysis, only the baseline radiographic damage score was significantly different from each other. In improved group, the change of damage scores was negatively associated with disease duration at baseline (r = 0.48, p = 0.024).

Conclusion  Our study demonstrated that radiographic damage in gout may be reversible to some extent and that the magnitude of improvement depends on the degree of serum uric acid control.


Disclosure:

S. Lee,
None;

I. Kim,
None;

H. Jeong,
None;

J. Hwang,
None;

H. Kim,
None;

J. Lee,
None;

H. S. Cha,
None;

E. M. Koh,
None.

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