Factors influencing the kinetics of monosodium urate (MSU) crystal depletion measured with dual-energy CT in patients with gout
Authors' conclusion
In patients with DECT-measured MSU crystal deposition, reaching the <5.0 mg/dL SU target provides more extensive and rapid crystal dissolution than reaching the <6.0 mg/dL SU target.
Study context
- Population
- Patients with gout with baseline knees and feet dual-energy computed tomography (DECT) MSU crystal volumes ≥0.1 cm³ and at least one follow-up DECT
- Participants
- 62 patients104 follow-up DECT scans
- Exposure
- Serum urate (SU) <5.0 mg/dL vs ≥5.0 SU <6.0 mg/dL
- SU <5.0 mg/dLn = 36
- Outcome
- Percentage change from baseline MSU crystal volume measured with DECT
Methodological detailslinear mixed models, DECT follow-up
- Linear mixed models
- DECT follow-up
Main finding
As reported in the abstract
Median % change from baseline MSU crystal volume · 12 months
SU <5.0 mg/dL
−85%
median · 95% CI −94%–-72%
≥5.0 SU <6.0 mg/dL
−40%
median · 95% CI −57%–-22%
P < 0.05
Observational data: associations, not effects.
Further findings
Correlation between SU level and % change in MSU crystal volume
- Spearman r
- 0.66
- P
- P < 0.0001
SU target achievement
- SU <6.0 mg/dL achieved
- 48 (77%)
- SU <5.0 mg/dL achieved
- 36 (58%)
Multivariable linear mixed model: variables associated with MSU crystal volume change
- Time (days), multilevel coefficient −0.06 (95% CI −0.08 to −0.03)
- P < 0.001
- Hypertension, coefficient 41.87 (95% CI 16.38 to 67.18)
- P < 0.01
- SU <5.0 mg/dL, coefficient −39.46 (95% CI −70.93 to −8.34)
- P = 0.02
- The only variables significantly associated
Original publication
Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout. RMD Open. Published 8 November 2023. doi:10.
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