AB0894 CHANGE OF ULTRASONOGRAPHIC SIGNS DURING URATE LOWERING THERAPY IN PATIENTS WITH GOUT

Abstract

Background US is widely used in clinical practise in gout diagnosis and follow up. However, the crystal resolution time is not widely studied in gout patients by ultrasonography. Objectives To explore related factors of changes in gouty patients by ultrasonography after initiation of uric acid lowering therapy. Methods There were 72 gout patients enrolled who admitted to First hospital of Peking University from December 2012 to June 2017. All the patients had clinical and ultrasound examination at both knees, ankles and feet joints at the baseline. Regular uric acid lowering therapy started for one year. The endpoint was the last time who repeat the ultrasound examination during the follow up. According with uric acid level and its measuring time, the area under the curve was calculated to reflect the uric acid burden. Results In the 216 joint regions of 72 patients, double contour sign were detectable in 112/216(;51.85%), tophi were detectable in 71/216(;32.87%). Among MTP Joints, DCS was detected in 32/144 (22.22%), and tophi in 47/144 (32.64%). Among Knee joints, DCS was detected in 33/144 (22.92%), tophi in 4/144 (2.78%). Among ankle joints, DCS was detected in 47/144(;32.64%), tophi in 20/144(;13.89%). DCS disappearance occurred in 38/55 (69.09%) joints positive for DCS at baseline.Time-to-disappearance was 148 days (63-985 days). Tophi disappeared completely in 18/45 joints (40%). Time-to-disappearance was 382.5 days(;397.25–686 days). There was no significant difference in age, BMI, duration of disease and complications between DCS persisted group and DCS disappearance group. SUA in the DCS disappeared group at baseline, second, third, fourth and ninth months of follow-up was significantly lower than that of the non-disappeared group. SUA load in the DCS group was significantly lower than the non-disappeared group. Post hoc tests showed that SUA levels fell significantly from baseline through fourth month of follow-up in DCS disappeared group, and SUA of the sixth months was the lowest. Conclusion To screen for specific features of gout such as DCS or tophi by US at initiation of ULT and during follow-up is a useful, and effective modality to detect the lowering and often disappearance of burden of urate load in gouty joints.