Background/Purpose: To investigate the clinical features and risk of gout recurrence in patients with normouricemia during an acute attack

Methods:

This study was conducted in patients diagnosed with acute gout attack by the presence of urate crystals. Clinical features of normouricemic and hyperuricemic patients were compared. Multivariate analysis was performed to determine whether normouricemic patients during an acute attack were less likely to have a recurrent gout attack.

Results: Among a total of 221 gout patients, 88 (39.8%) had normouricemia during an acute attack. Postsurgical gout (22.7% vs 6.0%, P < 0.001), hemodialysis initiation (9.1% vs 2.3%, P = 0.029) and inflammatory activity were higher in normouricemic patients than in hyperuricemic patients. The frequency of renal insufficiency was lower in normouricemic patients (25.0% vs 53.4%, P < 0.001). However, the recurrence rate of gout attack was not different between the two groups during the follow-up period (24.7% vs 33.0%, P = 0.220). In multivariate analysis, female sex, history of urinary stone, presence of tophi, and use of thiazide were associated with risk of recurrent gout attack, but not with serum urate status during an acute attack (HR 1.075, 95% CI 0.972-1.190, P = 0.159).

Conclusion: Normouricemia during an acute gout attack was more frequently observed in postsurgical episodes, hemodialysis initiation and patients with preserved renal function. The recurrent attack was not associated with serum urate levels during an acute gout attack. Thus, careful follow-up should be considered in gout patients regardless of serum urate levels during an acute attack.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-features-and-risk-of-recurrent-attack-in-gout-patients-according-to-serum-urate-levels-during-an-acute-gout-attack/