TY - JOUR T1 - Are target urate and remission possible in severe gout? A five-year cohort study JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.181214 SP - jrheum.181214 AU - Claudia Alvarado-de la Barrera AU - Carlos O. López-López AU - Everardo Álvarez-Hernández AU - Ingris Peláez-Ballestas AU - Citlallyc Gómez-Ruiz AU - Rubén Burgos-Vargas AU - Janitzia Vázquez-Mellado Y1 - 2019/05/01 UR - http://www.jrheum.org/content/early/2019/04/24/jrheum.181214.abstract N2 - Objective Determine the proportion of patients achieving target serum urate (sUA), defined as < 6 mg/dL for patients with non-severe gout and < 5 mg/dL for patients with severe gout, as well as the proportion of patients achieving remission after 5 years of follow-up. Methods Patients from the GRESGO cohort were evaluated at 6-month intervals. Demographic and clinical data were obtained at baseline. Visits included assessments of serum urate; flares; tophus burden; health-related quality of life, by using the EuroQol-5 Dimensions; activity limitations, by using the Health Assessment Questionnaire adapted for gout; and pain level and patient global assessment, by using visual analog scales. Treatment for gout and associated diseases was prescribed according to guidelines and available drugs. Results Of 500 patients studied, 221 had severe gout (44%) and 279 had non-severe gout (56%) at baseline. No significant differences were observed across the study in percentages of severe gout vs. non-severe gout patients achieving TU 6 mg/dL or 5 mg/dL. The highest proportion of patients achieving target sUA (50-70%) and remission (39%) were found after 3-4 years of follow-up. On the fifth year, these proportions decreased and 28% of the patients were on remission but only 40 patients remained in the study. None of the severe gout patients achieved remission. Conclusion In severe gout patients, target sUA was hard to achieve and remission was not possible. The main obstacles for target sUA and gout remission include poor medication adherence, persistent tophi and loss to follow-up. ER -