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Ultrasound shows improvement, lingering Doppler signal in patients with gout after ULT
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Urate-lowering therapy reduced symptoms and synovitis in patients with gout; however, after 2 years of treatment, a Doppler signal persists in many asymptomatic patients, suggesting subclinical disease activity is present, according to findings from a recently published study.
A longitudinal, 2-year study was conducted among 24 patients with gout (23 men; mean age: 60.8 years) and confirmed monosodium urate crystals in aspirates from symptomatic joints. Median disease duration was 10.3 years, and patients were treated with colchicine, allopurinol or NSAIDs. At the last visit, prophylactic colchicine continued in 14 patients, 17 patients were treated with allopurinol, four were treated with both allopurinol and benzbromarone, and the remaining patients did not comply with treatment.
Ultrasound with a Logiq 9 system (GE Medical Systems), a 9-MHz to 14-MHz gray scale probe and a 5-MHz to 7.5-MHz Doppler probe, as well as the Patient Global Assessment (PGA), were performed at baseline and at 6, 12 and 24 months of follow-up. Ultrasound examination was conducted in both knees and both metatarsophalangeal joints.
Blood uric acid concentration was lowered to 6 mg/dL in 62% of patients after 6 months and 12 months, according to the researchers. PGA scores and swollen and tender joint counts improved, and flares were reduced. However, changes in the erythrocyte sedimentation rate and C-reactive protein did not reach significance, the researchers reported.
Although the Doppler score was reduced during the course of 1 year and 2 years, a Doppler signal was observed in 50% of total scanned regions, and 95.8% of patients showed a Doppler signal in at least one scanned joint. A Doppler signal was observed in 52% of first metatarsophalangeal joints, and 76% of the knees examined showed a Doppler signal, suggesting persistent subclinical disease activity may be present, according to the researchers. - by Shirley Pulawski
Disclosure : The researchers report no relevant financial disclosure.
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