Rheumatology

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Serum urate during acute gout
Journal of Rheumatology, 06/12/09

Schlesinger N et al. – A normal serum urate (SU) level at presentation does not exclude an acute gouty attack, possibly attributed to persistence of tophi and an increased body uric acid pool. Additional studies are needed to determine the correlation between SU and the body uric acid pool as well as the relationship to timing of changes during acute gout.

• Aim was to study the frequency of normal SU levels during acute gout
• Data collected from 2 randomized controlled clinical trials assessing the efficacy of etoricoxib or indomethacin for 7 days
• SU levels during acute gouty attacks were assessed
• Efficacy was similar with both agents, so both groups were combined for analysis

• 339 pts enrolled in the 2 studies; 94% male; mean age: 50.5 yrs
• At baseline, 14% of pts had a “true” normal SU (≤6 mg/dl) and 32% had SU ≤8 mg/dl during acute gout
• Baseline mean SU was 7.1 vs 8.5 mg/dl in those taking allopurinol vs nonusers
• Pts taking chronic allopurinol were more likely to have lower SU at baseline vs those not taking chronic allopurinol during the acute attack

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