Background/Purpose: To evaluate the clinical factors on gout flare during urate lowering treatment

Methods:

We retrospectively examined data derived from 228 patients who had been treated with urate lowering agent more than six months after stopping prophylactic medication at multicenter rheumatology clinics. Demographic data (age, sex, disease duration, tophi and comorbidity), clinical and laboratory features including presence of gout flare during only urate lowering treatment, kinds and dose of urate lowering agents, serum uric acid, fasting glucose, lipid profile and creatinine clearance were collected at the initiation of urate lowering treatment and at the six months after stopping prophylaxis.

Results:

Mean age of patients was 51.3 years, mean disease duration was 28.9 months, and mean body mass index was 27.5. Male to female ratio was 225:3. Starting urate lowering agents were allopurinol 84.6%, febuxostat 0.9%, and uricosuric agents 14.5%. Seventy-seven patients among 228 cases(33.8%) had experienced at least 1 gouty attack during only urate lowering therapy. Mean duration of prophylactic medication was shorter in flare group (9.1 months) than in non- flare group (11.3 months, p=0.042). At the time of stopping prophylaxis, mean serum uric acid level was 6.2 mg/dL (6.5 mg/dL vs. 6.0 mg/dL, p=0.071). According to the duration of prophylactic treatment (< 6months, ≥6months), there were more frequent flares in the < 6 months group than ≥ 6 months group (41.7% vs. 25.7%, p=0.012). At the time of stopping prophylaxis, mean serum uric acid level was 6.8 mg/dL vs. 5.6 mg/dL, p=0.000 respectively.

Conclusion: