Effects of Conventional Uric Acid–Lowering Therapy on Monosodium Urate Crystal Deposits

dc.contributor.authorEllmann, Hanna
dc.contributor.authorBayat, Sara
dc.contributor.authorAraujo, Elizabeth
dc.contributor.authorManger, Bernhard
dc.contributor.authorKleyer, Arnd
dc.contributor.authorCavallaro, Alexander
dc.contributor.authorLell, Michael
dc.contributor.authorSchenker, Hannah
dc.contributor.authorSimon, David
dc.contributor.authorTascilar, Koray
dc.contributor.authorBaraf, Herbert S. B.
dc.contributor.authorSchett, Georg
dc.contributor.authorRech, Jürgen
dc.date.accessioned2020-10-01
dc.date.available2023-10-09T22:59:17Z
dc.date.created2020
dc.date.issued2020-10-01
dc.description.abstractObjective Few studies have systematically and quantitatively addressed the impact of urate‐lowering therapy on monosodium urate (MSU) deposits. This study was undertaken to analyze the effect of lifestyle measures and conventional urate‐lowering therapy on MSU deposits in patients with gout. Methods In this prospective study, subjects with gout according to the American College of Rheumatology/European League Against Rheumatism classification criteria and presence of MSU deposits seen on dual‐energy computed tomography (DECT) scans received either lifestyle intervention or conventional urate‐lowering therapy for a mean period of 18 months before a follow‐up DECT scan. Detected MSU deposits were quantified by volumetric measurement and validated by semiquantitative scoring, and baseline and follow‐up measurements were compared. Results Baseline and follow‐up DECT scans were available for all 83 subjects. Six subjects discontinued treatment, and 77 subjects underwent a lifestyle intervention (n = 24) or were treated with allopurinol (n = 29), febuxostat (n = 22), or benzbromarone (n = 2) over the entire observation period. The mean serum uric acid (UA) level decreased from 7.2 to 5.8 mg/dl in the overall population. In patients who discontinued treatment, no change in MSU deposits or serum UA levels was observed. The burden of MSU deposits significantly decreased in patients undergoing lifestyle intervention (MSU volume P = 0.007; MSU score P = 0.001), and in patients treated with allopurinol (MSU volume and score P < 0.001) or febuxostat (MSU volume P < 0.001; MSU score P = 0.001). No significant decline in MSU deposits was noted in patients who discontinued treatment. Conclusion These data show that lifestyle intervention and xanthine oxidase inhibitors significantly decrease the MSU deposit burden. Hence, conventional gout therapy not only lowers serum UA levels, but also reduces pathologic MSU deposits.en
dc.format.extent6
dc.identifier.citationArthritis & Rheumatology 72.1 (2020): 150-156. <https://onlinelibrary.wiley.com/doi/full/10.1002/art.41063>
dc.identifier.doihttps://doi.org/10.1002/art.41063
dc.identifier.opus-id14619
dc.identifier.urihttps://open.fau.de/handle/openfau/14619
dc.identifier.urnurn:nbn:de:bvb:29-opus4-146198
dc.language.isoen
dc.rights.urihttps://creativecommons.org/licenses/by-nc/4.0/deed.de
dc.subject.ddcDDC Classification::6 Technik, Medizin, angewandte Wissenschaften :: 61 Medizin und Gesundheit :: 610 Medizin und Gesundheit
dc.titleEffects of Conventional Uric Acid–Lowering Therapy on Monosodium Urate Crystal Depositsen
dc.typearticle
dcterms.publisherFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
local.date.prevpublished2019-12-27
local.document.pageend156
local.document.pagestart150
local.journal.issue1
local.journal.titleArthritis & Rheumatology
local.journal.volume72
local.sendToDnbfree*
local.subject.fakultaetMedizinische Fakultät
local.subject.gnd-
local.subject.importimport
local.subject.sammlungUniversität Erlangen-Nürnberg / Eingespielte Open Access Artikel / Eingespielte Open Access Artikel 2020
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