Real-world persistence of urate-lowering therapy following a treat-to-target intervention: A two-year follow-up analysis of the STOP gout trial
Authors' conclusion
Though interventions implementing treat-to-target ULT have demonstrated efficacy in trials, this study suggests that such interventions may have limited durability following transitions back to real-world gout management.
Study context
- Population
- Participants completing the 72-week STOP Gout trial with available follow-up data extending 2 years post-study (99% male; mean age 62.7 years)
- Participants
- 638 participants
- Primary endpoint
- ULT persistence: a ULT dispensing episode overlapping with the 2-year post-study time point
- Follow-up
- 2 years post-study
Methodological details2-year post-study follow-up, passive follow-up using administrative and electronic health record data, multivariable logistic regression
- 2-year post-study follow-up
- Passive follow-up using administrative and electronic health record data
- Multivariable logistic regression
Primary result
As reported in the abstract
ULT persistence
Continued urate-lowering therapy (ULT)
66 %
Further findings
| Outcome | aOR (95 % CI) | |
|---|---|---|
| ULT persistence by rheumatology visits post-study · 2-years post-study≥2 rheumatology visits post-studyvs noneAssociated with greater ULT persistence · multivariable logistic regression, adjusted for covariates | 1.75 (1.13–2.72) | |
| 0.20.5125Adjusted odds ratio (log scale) |
ULT persistence by Black/African American race · 2-years post-study
| aOR (95 % CI) | ||
|---|---|---|
| Black/African American raceULT persistence lower | 0.56 (0.36–0.87) | |
| 0.20.5125Adjusted odds ratio (log scale) |
ULT persistence by Hispanic ethnicity · 2-years post-study
| aOR (95 % CI) | ||
|---|---|---|
| Hispanic ethnicityULT persistence lower | 0.21 (0.09–0.50) | |
| 0.050.21520Adjusted odds ratio (log scale) |
ULT persistence by achievement of serum urate goal at 48-weeks during STOP Gout · 2-years post-study
| aOR (95 % CI) | ||
|---|---|---|
| Achievement of serum urate goal at 48-weeks | 1.68 (0.99–2.85) | |
| 0.20.5125Adjusted odds ratio (log scale) |
- ULT persistence by achievement of serum urate goal at 48-weeks during STOP Gout: not reaching significance; borderline association with greater long-term persistence
ULT persistence by quality-of-life at start of post-study follow-up · 2-years post-study
- ULT persistence lower with better quality-of-life at the beginning of post-study follow-up
Original publication
Real-world persistence of urate-lowering therapy following a treat-to-target intervention: A two-year follow-up analysis of the STOP gout trial. Semin Arthritis Rheum. Published 5 August 2025. doi:10.
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