Long-Term Impact of Treat-to-Target Urate-Lowering Therapy on Ultrasound-Detected Crystal Depositions and Clinical Outcomes: Insights from the 5-Year NOR-Gout Study
Five years of treat-to-target urate-lowering therapy (T2T-ULT) significantly reduces serum uric acid (sUA) levels and ultrasonographically detected monosodium urate crystal deposits in gout patients.
Complete dissolution of ultrasound-detected double contour and tophi occurs in the majority of patients, with assessment of first metatarsophalangeal joints proving most informative.
Long-term therapy substantially reduces clinical gout flares, with residual flares associated with higher sUA and crystal burden.
Gout remission rates increase markedly over 5 years using various remission criteria, correlating with improved quality of life and structural improvements.
High medication adherence over 5 years is critical for urate target achievement and flare prevention; younger age, non-European origin, and lower mental health scores predict non-adherence.
