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Dont be fooled by normal serum urate in acute gout
Rheumatology News, 08/21/08
Schlesinger N – Serum urate levels are often normal during acute gouty arthritis attacks.
Methods- 339 pts with acute gouty arthritis whose serum urate levels were measured
- Laboratory measurements including serum urate as assessed by the uricase enzyme method were obtained at baseline and on d 2, 5, and 8
- These pts were participants in one of two earlier randomized clinical trials assessing the efficacy of 1 week of etoricoxib or indomethacin therapy in acute gout
- Complete data for both studies was combined because efficacy was similar for both drugs
- The mean serum urate at baseline was 7.6 mg/dL in pts on long-term allopurinol and 8.5 mg/dL in those who weren't
- On day 8, following a week of NSAID therapy, the mean serum urate was 7.4 mg/dL in those on allopurinol and 8.7 mg/dL in those who were not
- Pts with a history of >4 gouty attacks/yr or with polyarticular attacks had higher serum urate during the episode studied than those w/o those characteristics
- 29% of individuals on chronicallopurinol had a true-normal serum urate level, defined as ≤6 mg/dL
- Among pts not on the hypouricemic agent, 11% had a true-normal serum urate level during their acute episode of gout
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