Gout is a major problem for the population in Norway. Despite good and readily available medication, the disease is far from being optimally treated and patients retain high levels of uric acid, suffer recurrent attacks and functional impairment as well as the deposition of uric acid crystals in the tissues.
In this study, we investigate whether a low level of uric acid in the blood after targeted treatment prevents new attacks of gout and reduces the deposition of crystals in the tissues (joints, tendons and skin). For this purpose, we established a cohort of gout patients who came to the rheumatology outpatient clinic after an acute attack of arthritis. After treatment of the acute attack, the 211 included patients were treated for the first year with close follow-up and a clear treatment target according to the "treat-to-target" principle.
The study is being conducted at the rheumatology outpatient clinic, Diakonhjemmet Hospital in collaboration with the National Competence Center for Rheumatological Rehabilitation (NKRR), and the project will show whether targeted treatment with uric acid-lowering medication and lifestyle advice from a nurse with frequent follow-up results in fewer attacks and the removal of uric acid crystals from the body. The project also involves collaboration with radiologists, heart researchers and international researchers, and clinical data will be linked, for example to genetic analyses.
The study included adult patients with gout with a recent attack and an elevated uric acid level in the blood.
Recruitment of patients has been completed and patients are followed up with a survey also after 5 years.
Patients were treated with a targeted intervention involving a consultation with the study nurse at the rheumatology outpatient clinic and uric acid-lowering medication. Follow-up with the nurse was done every month if necessary until the treatment goal of low uric acid levels was reached. Follow-up with a doctor at fixed time intervals (3, 6, 12, 24, 60 months) was also done with ultrasound examination. Furthermore, X-ray examination with CT was performed and patients are followed up for 5 years. Questionnaires also examine health-related quality of life and work productivity.