Sébastien Ottaviani1, Ghislaine Gill2, Aurore Aubrun2, Elisabeth Palazzo2, Olivier Meyer2, Philippe Dieudé2. 1. Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France. Electronic address: sebastien.ottaviani@bch.aphp.fr. 2. Service de rhumatologie, hôpital Bichat, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, UFR de médecine, 75205 Paris, France.
Abstract
OBJECTIVE: We aimed to determine the ability of ultrasonography (US) to show decrease or disappearance of urate deposits in gouty patients requiring urate-lowering therapy (ULT). METHODS: To be included in this prospective single-centre study, patients needed toexhibit (1) proven gout by monosodic urate (MSU) crystals in synovial fluid and (2) US-evidenced urate deposits (double contour [DC] sign and/or tophi) before starting ULT (allopurinol [n=4], febuxostat [n=12]). At baseline and after six months of ULT, one trained ultrasonographer assessed the knee and first metatarsophalangeal (MTP1s) joints. Serum uric-acid (SUA) level was assessed at baseline and at three and six months after ULT initiation. Correlation between US findings and achievement of SUA level objective (< 360μmol/L) was estimated by the kappa coefficient (κ). RESULTS: We studied 16 patients (all males, mean age 61.0±18.3 years). The mean disease duration was 7.1±6.2 years. Tophi were found at clinical examination in 56% of patients. Baseline SUA levels were 688±153μmol/L. At baseline, US revealed tophi or a DC sign among 62.5 to 75% of patients in knees and 87.5% in MTP1s. After six months of ULT, none of the four patients, not achieving the SUA level objective, had disappearance of US features. Among the remaining 12 patients, US features (tophi or DC sign) disappeared or decreased in all but one with a stable DC sign in one MTP1. The correlation between the whole US examination and SUA level was excellent (κ=0.875). CONCLUSIONS: US could show disappearance of urate deposits after ULT and appears to be well correlated with efficacy of ULT.
OBJECTIVE: We aimed to determine the ability of ultrasonography (US) to show decrease or disappearance of urate deposits in gouty patients requiring urate-lowering therapy (ULT). METHODS: To be included in this prospective single-centre study, patients needed toexhibit (1) proven gout by monosodic urate (MSU) crystals in synovial fluid and (2) US-evidenced urate deposits (double contour [DC] sign and/or tophi) before starting ULT (allopurinol [n=4], febuxostat [n=12]). At baseline and after six months of ULT, one trained ultrasonographer assessed the knee and first metatarsophalangeal (MTP1s) joints. Serum uric-acid (SUA) level was assessed at baseline and at three and six months after ULT initiation. Correlation between US findings and achievement of SUA level objective (< 360μmol/L) was estimated by the kappa coefficient (κ). RESULTS: We studied 16 patients (all males, mean age 61.0±18.3 years). The mean disease duration was 7.1±6.2 years. Tophi were found at clinical examination in 56% of patients. Baseline SUA levels were 688±153μmol/L. At baseline, US revealed tophi or a DC sign among 62.5 to 75% of patients in knees and 87.5% in MTP1s. After six months of ULT, none of the four patients, not achieving the SUA level objective, had disappearance of US features. Among the remaining 12 patients, US features (tophi or DC sign) disappeared or decreased in all but one with a stable DC sign in one MTP1. The correlation between the whole US examination and SUA level was excellent (κ=0.875). CONCLUSIONS: US could show disappearance of urate deposits after ULT and appears to be well correlated with efficacy of ULT.
Authors: Eleonora Norkuviene; Mykolas Petraitis; Indre Apanaviciene; Dalia Virviciute; Asta Baranauskaite Journal: J Int Med Res Date: 2017-06-15 Impact factor: 1.671
Authors: Edoardo Cipolletta; Jacopo Di Battista; Marco Di Carlo; Andrea Di Matteo; Fausto Salaffi; Walter Grassi; Emilio Filippucci Journal: Arthritis Res Ther Date: 2021-07-09 Impact factor: 5.156