Recurrent Gout and Serum Urate —Reply

In Reply Our recent article quantified the role of serum urate, the central causal biomarker for gout, and found graded associations with recurrent gout flares, including those resulting in hospitalizations (with 100% of these cases associated with serum urate ≥5 mg/dL). Regarding the comments from Drs Chang and Hung, our study did not directly evaluate whether urate-lowering therapy affects gout flares, but rather one of our subgroup analyses tested whether the degree of association of serum urate with flares differed between those treated with urate-l owering therapy vs those not treated with urate-lowering therapy and found no difference—the strong graded association was evident similarly among those treated with urate-lowering therapy. As such, these population-based real-world findings closely agree with the flare benefits of lowering serum urate levels with urate-lowering therapy in the treat-to-target serum urate group of recent trials, as well as with rheumatology management guidelines for treat-to-target serum urate (<6 or<5 mg/dL [urate crystal subsaturation points]) with urate-lowering therapy.
Source: JAMA - Journal of the American Medical Association - Category: General Medicine Source Type: research