Prediction of renal and cardiometabolic outcomes in gout during urate-lowering therapy by sonography
© 2023 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd..
OBJECTIVES: To assess whether the extent of monosodium urate (MSU) crystal deposition estimated by ultrasound could predict renal and cardiometabolic events during urate-lowering therapy (ULT).
METHODS: A prospective study on gout patients from two referral centers initiating ULT who underwent baseline ultrasound and were followed for 1 year. Ultrasound scans assessed six joints for double-contour (DC) signs and tophi. A five-point change (mL/min/1.73 m2 ) in the glomerular filtration rate at month 12 (M12) was considered significant. Outcomes of interest were renal function degraded versus improved and a composite cardiometabolic outcome (new hypertension, diabetes, atherosclerotic disease, and cardiovascular death). Homogeneity analyses and Cox regression models were performed.
RESULTS: One hundred sixty patients were recruited. At baseline, 81.1% of patients (n = 129) showed sonographic tophi with a mean number of 1.4 joints (±1.3) with a DC sign. At M12, 18 patients (11.3%) were lost to follow-up. The serum urate (SU) target (<6.0 mg/dL) was reached in 86 patients (69.9%). Regarding renal function, 15.9% of patients showed improvement, while in 31.0% it degraded. Fourteen new cardiometabolic events occurred in 12 patients. Neither the DC sign nor tophi showed any significant impact on the outcomes of interest. Baseline SU level was higher in those with renal improvement but not with renal decline, while achieving the SU target protected against new cardiometabolic events (HR = 0.2; 95% CI: 0.05-0.81).
CONCLUSIONS: Sonographic MSU crystal burden was unhelpful in predicting renal and cardiometabolic events during the first year of ULT. Reaching the SU target prevented cardiometabolic events, while its benefit in preserving/improving renal function is unclear.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:26 |
|---|---|
| Enthalten in: |
International journal of rheumatic diseases - 26(2023), 12 vom: 02. Dez., Seite 2450-2459 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Calabuig, Irene [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
268B43MJ25 |
|---|
| Anmerkungen: |
Date Completed 04.12.2023 Date Revised 04.12.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1111/1756-185X.14935 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM362801126 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM362801126 | ||
| 003 | DE-627 | ||
| 005 | 20231226092010.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1111/1756-185X.14935 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1209.xml |
| 035 | |a (DE-627)NLM362801126 | ||
| 035 | |a (NLM)37786305 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Calabuig, Irene |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prediction of renal and cardiometabolic outcomes in gout during urate-lowering therapy by sonography |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 04.12.2023 | ||
| 500 | |a Date Revised 04.12.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 The Authors. International Journal of Rheumatic Diseases published by Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd. | ||
| 520 | |a OBJECTIVES: To assess whether the extent of monosodium urate (MSU) crystal deposition estimated by ultrasound could predict renal and cardiometabolic events during urate-lowering therapy (ULT) | ||
| 520 | |a METHODS: A prospective study on gout patients from two referral centers initiating ULT who underwent baseline ultrasound and were followed for 1 year. Ultrasound scans assessed six joints for double-contour (DC) signs and tophi. A five-point change (mL/min/1.73 m2 ) in the glomerular filtration rate at month 12 (M12) was considered significant. Outcomes of interest were renal function degraded versus improved and a composite cardiometabolic outcome (new hypertension, diabetes, atherosclerotic disease, and cardiovascular death). Homogeneity analyses and Cox regression models were performed | ||
| 520 | |a RESULTS: One hundred sixty patients were recruited. At baseline, 81.1% of patients (n = 129) showed sonographic tophi with a mean number of 1.4 joints (±1.3) with a DC sign. At M12, 18 patients (11.3%) were lost to follow-up. The serum urate (SU) target (<6.0 mg/dL) was reached in 86 patients (69.9%). Regarding renal function, 15.9% of patients showed improvement, while in 31.0% it degraded. Fourteen new cardiometabolic events occurred in 12 patients. Neither the DC sign nor tophi showed any significant impact on the outcomes of interest. Baseline SU level was higher in those with renal improvement but not with renal decline, while achieving the SU target protected against new cardiometabolic events (HR = 0.2; 95% CI: 0.05-0.81) | ||
| 520 | |a CONCLUSIONS: Sonographic MSU crystal burden was unhelpful in predicting renal and cardiometabolic events during the first year of ULT. Reaching the SU target prevented cardiometabolic events, while its benefit in preserving/improving renal function is unclear | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a cardiovascular diseases | |
| 650 | 4 | |a glomerular filtration rate | |
| 650 | 4 | |a gout | |
| 650 | 4 | |a gout suppressants | |
| 650 | 4 | |a kidney function tests | |
| 650 | 4 | |a ultrasonography | |
| 650 | 7 | |a Uric Acid |2 NLM | |
| 650 | 7 | |a 268B43MJ25 |2 NLM | |
| 650 | 7 | |a Gout Suppressants |2 NLM | |
| 700 | 1 | |a Marty-Ané, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Norberciak, Laurène |e verfasserin |4 aut | |
| 700 | 1 | |a Budzik, Jean-François |e verfasserin |4 aut | |
| 700 | 1 | |a Legrand, Julie |e verfasserin |4 aut | |
| 700 | 1 | |a Martínez-Sanchis, Agustín |e verfasserin |4 aut | |
| 700 | 1 | |a Pascart, Tristan |e verfasserin |4 aut | |
| 700 | 1 | |a Andrés, Mariano |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t International journal of rheumatic diseases |d 2009 |g 26(2023), 12 vom: 02. Dez., Seite 2450-2459 |w (DE-627)NLM197180566 |x 1756-185X |7 nnns |
| 773 | 1 | 8 | |g volume:26 |g year:2023 |g number:12 |g day:02 |g month:12 |g pages:2450-2459 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1111/1756-185X.14935 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 26 |j 2023 |e 12 |b 02 |c 12 |h 2450-2459 | ||