Duration and dose of allopurinol needed to attain the serum urate target in gout
Authors' conclusion
Treat-to-target ULT using allopurinol leads to attainment of the SU target within 2-3 months at low doses for most patients. Very few patients did not achieve the treatment target at least once during year 1.
Study context
- Population
- Patients with gout in the NOR-Gout prospective cohort with a recent gout flare and serum urate (SU) > 360 μmol/L95.2% male
- Participants
- 211 patients
- Outcome
- Treatment duration and allopurinol dose required to attain the SU target (< 360 μmol/L; < 6 mg/dL)
Methodological detailstreat-to-target, escalating allopurinol dosing, switch to febuxostat if needed
- Treat-to-target
- Escalating allopurinol dosing, switch to febuxostat if needed
Main finding
As reported in the abstract
- Median time to attaining treatment target (months)
- 2
- Mean time to attaining treatment target (months)
- 2.9
- Median allopurinol dose (mg)
- 200
- Mean allopurinol dose (mg)
- 243
- Patients reaching treatment target by 3 months
- Eighty per cent
- Target SU attained at least once during year 1
- 197 patients (93.4%)
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Median time to target SU by baseline SU (>480 vs <480 μmol/L)Median 3 months vs 2 months | log-rank p < 0.001 |
Mean SU (μmol/L) over time · baseline, 1 year, 2 years
- Mean SU at baseline (μmol/L)
- 500
- Mean SU at 1 year (μmol/L)
- 312
- Mean SU at 2 years (μmol/L)
- 325
Switch to febuxostat · year 1 and year 2
- Switch to febuxostat at year 1
- 12.4%
- Switch to febuxostat at year 2
- 15.1%
Original publication
Duration and dose of allopurinol needed to attain the serum urate target in gout. Scand J Rheumatol. Published 23 April 2026. doi:10.
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