Kyeong Min Son

Do H, et al. J Korean Med Sci. 2026 Nov;41:e296. https://doi.org/10.3346/jkms.2026.41.e296

Objective: Gout, an inflammatory arthritis caused by hyperuricemia, is highly prevalent with chronic kidney disease (CKD). We evaluated longitudinal changes in serum urate (SU) levels and febuxostat dosage according to renal function. Methods: Among 405 patients in the Urate-Lowering Therapy in Gout (ULTRA) registry between November 2021 and December 2023, 112 were analyzed after excluding those with < 1-year follow-up period, nonfebuxostat therapy, or missing data. SU levels and febuxostat doses were compared between the 2 groups at baseline, 6, and 12 months. Results: Baseline SU levels did not differ between the normal and CKD groups. After febuxostat therapy, mean (SD) SU levels were significantly lower in the CKD group than in the normal group (at 6 months: 4.45 [1.84] mg/dL vs 5.62 [1.62] mg/dL, P = 0.001; at 12 months: 4.81 [1.81] mg/dL vs 5.60 [1.94] mg/dL, P = 0.04). Meanwhile, the mean dosages of febuxostat were lower in CKD group than in the normal group (at 6 months: 40.61 [22.07] mg vs 47.54 [19.43] mg, P = 0.11; at 12 months: 40.59 [21.73] mg vs 48.49 [19.70] mg, P = 0.06), although these differences were not statistically significant. Additionally, the proportion of patients achieving SU < 6 mg/dL at 6 months was higher in the CKD group than in the normal group (91.2% vs 68.6%, P = 0.01). Conclusion: An individualized dosing strategy based on SU response, rather than renal function alone, may optimize treatment outcomes in these patients.

Achieving target serum uric acid (SUA) levels is important in gout management. Guidelines recommend lowering SUA levels to < 6 mg/dL; however, many patients fail to reach this target, even with uric acid-lowering therapy (ULT). This study investigated clinical characteristics of target SUA achievers among Korean patients with gout. This study used data from the ULTRA registry, a nationwide inception cohort established in September 2021 that enrolls patients with gout who initiate ULT. Demographic, clinical, and laboratory data were collected at baseline; the 6-month follow-up. Patients were divided into two groups: target achievers (SUA level < 6 mg/dL at 6 months) and non-achievers. The mean participant (N = 117) age was 56.1 years, and 88.0% were male. At 6 months, 83 patients (70.9%) reached target SUA levels. Target achievers had better drug adherence (≥ 80%) to ULT (97.6% vs. 76.5%; p < 0.01) than non-achievers. Target non-achievers had a higher percentage of a family history of gout (32.4% vs. 10.8%; p < 0.01) and less antihypertensive agent use (38.2% vs. 59.0%; p = 0.03) than target achievers. Multivariate regression analysis revealed that good adherence to ULT, the absence of a family history of gout, and antihypertensive agent use were key factors associated with achieving target SUA levels at 6 months.

Son KM, et al. J Korean Rheum Assoc. 2010 Jun;17(2):162-167. http://dx.doi.org/10.4078/jkra.2010.17.2.162