Ultrasound evaluation in follow-up of urate-lowering therapy in gout: the USEFUL study
| Autor: | Sébastien Ottaviani, Claire Brière, Thomas Bardin, Pascal Richette, Jérémy Ora, Marine Forien, Hang-Korng Ea, Frédéric Lioté, Esther Ebstein, E. Norkuviene, Philippe Dieudé, Gaël Mouterde, Claire Daien, Mykolas Petraitis |
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| Přispěvatelé: | AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Lariboisière-Fernand-Widal [APHP], Biologie de l'Os et du Cartilage : Régulations et Ciblages Thérapeutiques (BIOSCAR (UMR_S_1132 / U1132)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP), Département de Rhumatologie[Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie, Institut de Génétique Moléculaire de Montpellier (IGMM), Centre National de la Recherche Scientifique (CNRS)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier) |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
Metatarsophalangeal Joint medicine.medical_specialty Knee Joint Urology Metatarsophalangeal joints Decreased size Gout Suppressants 03 medical and health sciences 0302 clinical medicine gout Rheumatology medicine Humans Pharmacology (medical) 030212 general & internal medicine Prospective cohort study Aged Ultrasonography 030203 arthritis & rheumatology business.industry ultrasound Ultrasound Tophus Middle Aged medicine.disease Gout Serum urate urate lowering therapy medicine.anatomical_structure Treatment Outcome Female business management [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology Follow-Up Studies |
| Zdroj: | Rheumatology Rheumatology, Oxford University Press (OUP), 2019, 58 (3), pp.410-417. ⟨10.1093/rheumatology/key303⟩ |
| ISSN: | 1462-0324 1460-2172 |
| DOI: | 10.1093/rheumatology/key303⟩ |
| Popis: | International audience; OBJECTIVES:We aimed to determine the ability of ultrasonography (US) to show disappearance of urate deposits in gouty patients requiring urate-lowering therapy (ULT).METHODS:We performed a 6-month multicentre prospective study including patients with: proven gout; presence of US features of gout (tophus and/or double contour sign) at the knee and/or first metatarsophalangeal joints; and no current ULT. US evaluations were performed at baseline and at months 3 and 6 (M3, M6) after starting ULT. Outcomes were: the change in US features of gout at M6 according to final (M6) serum urate (SU) level (high, > 360 μmol/l, i.e. > 6 mg/dl; low, 300-360 μmol/l, i.e. 5-6 mg/dl; very low, < 300 μmol/l, i.e. < 5 mg/dl); and correlation between changed US features and final SU level.RESULTS:We included 79 gouty patients (mean ± s.d., age 61.8 (14) years, 91% males, disease duration 6.3 (6.1) years). Baseline SU level was 530 ± 97 µmol/l (i.e. 8.9 mg/dl ± 1.6mg/dl). At least one US tophus and double contour sign was observed in 74 (94%) and 68 (86%) patients, respectively. Among the 67 completers at M6, 18 and 39 achieved a very low and low SU level, respectively. We found a significant decrease in US features of gout among patients with the lowest SU level (P < 0.001). Final M6 SU level was positively correlated with decreased size of tophus (r = 0.54 [95% CI: 0.34, 0.70], P < 0.0001), and inversely correlated with proportion of double contour sign disappearance (r=-0.59 [-0.74, -0.40]).CONCLUSION:US can show decreased urate deposition after ULT, which is correlated with decreased SU level. The responsiveness of US in gout is demonstrated and can be useful for gout follow-up and adherence to ULT. |
| Databáze: | OpenAIRE |
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