Are Target Urate and Remission Possible in Severe Gout? A Five-year Cohort Study

J Rheumatol. 2020 Jan;47(1):132-139. doi: 10.3899/jrheum.181214. Epub 2019 May 1.


Objective: Determine the proportion of patients achieving target serum urate (SU), defined as < 6 mg/dl for patients with non-severe gout and < 5 mg/dl for patients with severe gout, as well as the proportion of patients achieving remission after 5 years of followup.

Methods: Patients from the Gout Study Group (GRESGO) cohort were evaluated at 6-month intervals. Demographic and clinical data were obtained at baseline. Visits included assessments of serum urate, flares, tophus burden, health-related quality of life using the EQ-5D, activity limitations using the Health Assessment Questionnaire adapted for gout, and pain level and patient's global assessment using visual analog scales. Treatment for gout and associated diseases was prescribed according to guidelines and available drugs.

Results: Of 500 patients studied, 221 had severe gout (44%) and 279 had non-severe gout (56%) at baseline. No significant differences were observed across the study in percentages of severe gout versus non-severe gout patients achieving SU 6 mg/dl or 5 mg/dl. The highest proportion of patients achieving target SU (50-70%) and remission (39%) were found after 3-4 years of followup. In the fifth year, these proportions decreased and 28% of the patients were in remission, but only 40 patients remained in the study. None of the patients with severe gout achieved remission.

Conclusion: In patients with severe gout, target SU was hard to achieve and remission was not possible. The main obstacles for target SU and gout remission include poor medication adherence, persistent tophi, and loss to followup.


Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Female
  • Follow-Up Studies
  • Gout / blood*
  • Gout / drug therapy*
  • Gout / epidemiology
  • Gout Suppressants / therapeutic use*
  • Health Surveys
  • Humans
  • Longitudinal Studies
  • Male
  • Medication Adherence
  • Mexico / epidemiology
  • Middle Aged
  • Prospective Studies
  • Quality of Life
  • Remission Induction
  • Severity of Illness Index*
  • Treatment Outcome
  • Uric Acid / blood*
  • Visual Analog Scale
  • Young Adult


  • Gout Suppressants
  • Uric Acid