Are gout patients with negative dual-energy computed tomography for monosodium urate crystal deposition easy to treat?
Authors' conclusion
The 0.1 cm3 threshold was better correlated with clinical presentation and evolution than the 0.01 cm3 threshold. Gout patients with negative DECTs exhibit milder disease and a lower comorbidity burden. They do not exhibit particularly easy-to-treat hyperuricaemia but they may have a lower risk of flares.
Study context
- Population
- Gout patients naïve to urate-lowering therapy (ULT) with baseline dual-energy CT (DECT) scans of the knees and feet, CRYSTALILLE cohortmedian age 66.2 years
- Participants
- 211 participants
- Exposure
- Negative vs positive DECT for MSU crystal deposition
- <0.1 cm³n = 90
- <0.01 cm³n = 38
- Outcome
- Flares after ULT initiation
- Follow-up
- 6, 12 and 24 months
Methodological detailsCRYSTALILLE cohort, two DECT positivity thresholds (<0.01 cm³ and <0.1 cm³)
- CRYSTALILLE cohort
- Two DECT positivity thresholds (<0.01 cm³ and <0.1 cm³)
Main finding
As reported in the abstract
| Group | Value | 12 months | 24 months |
|---|---|---|---|
| <0.1 cm³ | 23.1% | 3/26 (11.5%) | 1/18 (5.6%) |
| ≥0.1 cm³ | 40.0% | 9/36 (25.0%) | 2/18 (11.1%) |
Value
<0.1 cm³23.1%
≥0.1 cm³40.0%
12 months
<0.1 cm³3/26 (11.5%)
≥0.1 cm³9/36 (25.0%)
24 months
<0.1 cm³1/18 (5.6%)
≥0.1 cm³2/18 (11.1%)
- <0.1 cm³ vs ≥0.1 cm³: P > 0.05
Observational data: associations, not effects.
Further findings
| Outcome | <0.1 cm³ | <0.01 cm³ |
|---|---|---|
| Negative DECT prevalence · baseline | 43% | 18% |
Negative DECT prevalence · baseline
- Factors associated with negative DECT: younger age, shorter symptom duration, absence of CVD (both thresholds)
Serum urate (SU) target attainment (overall)
- Reached SU <6.0 mg/dl
- 95 (68.3%)
- Reached SU <5.0 mg/dl
- 68 (48.9%)
- No difference between positive and negative DECTs; ULT doses tended to be lower with negative DECT
Original publication
Are gout patients with negative dual-energy computed tomography for monosodium urate crystal deposition easy to treat? Rheumatology (Oxford). Published 9 February 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →