Changes in Tophus Composition During Urate‐Lowering Therapy: A Dual‐Energy Computed Tomography Study
Authors' conclusion
The composition of the tophus is dynamic and changes during urate-lowering therapy for gout management. The soft tissue component of the tophus is slower to respond and may persist without measurable MSU crystal deposition.
Study context
- Population
- People with gout receiving allopurinol; up to 5 index tophi per patient103 tophi analysed
- Participants
- 32 people
- Exposure
- Tophus composition at baseline vs year 2 of allopurinol therapy
- Allopurinoln = 32
- Outcome
- Change in tophus composition (total tophus volume, urate volume, soft tissue volume) on DECT
- Follow-up
- 2 years
Methodological detailssecondary analysis of serial dual-energy computed tomography (DECT) scans, single-group
- Secondary analysis of serial DECT scans
- Single-group
Main finding
As reported in the abstract
Tophus composition change over 2 years · year 2
Mean ± SD total tophus volume, baseline to 2 years (cm³), P < 0.0001
5.17 ± 5.55 to 2.61 ± 2.73
Tophus urate volume decrease
70.6%
Tophus soft tissue volume decrease (urate vs soft tissue reduction, P < 0.0001)
37.8%
Mean tophus urate:soft tissue ratio, baseline to year 2 (P < 0.001)
0.15 to 0.05
Observational data: associations, not effects.
Further findings
- Serum urate, mean ± SD (mmoles/liter), baseline to year 2
- 0.43 ± 0.03 to 0.31 ± 0.02
Original publication
Changes in Tophus Composition During Urate‐Lowering Therapy: A Dual‐Energy Computed Tomography Study. Arthritis Care Res (Hoboken). Published 18 February 2023. doi:10.
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