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New urate depositions on dual-energy computed tomography in gouty arthritis during urate-lowering therapy

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Abstract

Reduction of urate depositions in the joints, on dual-energy computed tomography (DECT), in patients with gout during urate-lowering therapy (ULT) was demonstrated in previous studies. The aim of this study was to further investigate the changes in distribution of urate deposits during ULT. This randomized controlled trial enrolled 46 patients diagnosed with gout from Zhongshan Hospital, China, between October 2013 and June 2014. Epidemiological data, serum uric acid level, and arthritis attacks were recorded at monthly follow-up visits. DECT of bilateral feet and ankles was performed at baseline and after 6 months of ULT. Overall, 163 areas of urate deposition were found in the 46 patients; of these, 133/163 (81.6%) areas were associated with former arthritis attacks. On DECT at 6 months, the number of urate deposits decreased to 126, with 68 areas disappearing and 31 new deposits areas. The mean volume of urate deposits at baseline was 1.3 ± 3.8 cm3, decreasing to 0.6 ± 2.1 cm3 at the end of 6 months (P = 0.01), with 3/46 (6.5%) patients showing complete disappearance of urate deposits. New urate depositions were found in 21/46 (45.7%) patients, while urate depositions in some joints disappeared in some joints in 31/46 (67.4%) patients. High-sensitivity C-reactive protein was significantly lower in patients with new deposits (4.6 ± 9.3 vs. 7.1 ± 7.6 mg/dL; P = 0.01). There is dynamic redistribution of urate depositions in gout patients receiving ULT.

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Acknowledgements

This research was funded by Scientific Research Project from Health and Family Planning Commission of Shanghai, China (grant no. 20154Y0061) and Young Investigator Award of Zhongshan Hospital, Fudan university, China (grant no. 2015ZSQN21).

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Author notes

  1. Zhuojun Zhang and **aojie Zhang contributed equally to this study.

Authors and Affiliations

  1. Department of Rheumatology, Zhongshan Hospital, Fudan University, No. 180, Road Fenglin, Shanghai, 200032, People’s Republic of China

    Zhuojun Zhang, **aojie Zhang, Ying Sun, Huiyong Chen, **ufang Kong, Lili Ma & Lindi Jiang

  2. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China

    Jianjun Zhou & Yi Zhou

  3. Center of Clinical Epidemiology and Evidence-based Medicine, Fudan University, Shanghai, China

    Lindi Jiang

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  1. Zhuojun Zhang
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  6. Jianjun Zhou
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Correspondence to Lindi Jiang.

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Conflict of interest

Zhuojun Zhang declares that she has no conflict of interest. **aojie Zhang declares that she has no conflict of interest. Ying Sun declares that she has no conflict of interest. Huiyong Chen declares that he has no conflict of interest. **ufang Kong declares that she has no conflict of interest. Jianjun Zhou declares that he has no conflict of interest. Yi Zhou declares that he has no conflict of interest. Lili Ma declares that she has no conflict of interest. Lindi Jiang declares that she has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Zhang, Z., Zhang, X., Sun, Y. et al. New urate depositions on dual-energy computed tomography in gouty arthritis during urate-lowering therapy. Rheumatol Int 37, 1365–1372 (2017). https://doi.org/10.1007/s00296-017-3724-3

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  • DOI: https://doi.org/10.1007/s00296-017-3724-3

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