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Urate Lowering Therapy During Acute Gout

Jan 26, 2021 3:56 pm

Acute gout has its well defined protocols, and most state that urate lowering therapy (ULT) should be continued; but does ULT affect outcomes in an acute gout attack?

A systematic review identifed six randomized controlled trials, with 557 acute gout patients included. Results showed that at day 3 of the attack there was no statistical difference in the pain visual analogue scores.  Nor was there a difference between groups (those on ULT vs. not on ULT) in the ESR and CRP.

Patients using ULT agents had lower serum uric acid level (mean difference − 0.73; P < 0.00001) and showed 40% better adherence to medication. However, there was no difference in the recurrence rate of acute gout attacks between those on and off ULT during the acute gout attack.

These data suggest a negligible effect of ULT maintenance in the an acute gout attack. 

The author has no conflicts of interest to disclose related to this subject

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