Time Required to Dissolve Urate Deposits
Time Required to Dissolve Urate Deposits in Patients With Gout
Assistance Publique - Hôpitaux de Paris
250 participants
Sep 24, 2024
OBSERVATIONAL
Conditions
Summary
Gout is characterized by episodes of acute arthritis of the lower limbs due to intermittent activation of innate immunity in the joints where urate crystals have formed. These crystals occur when serum urate (SUA) levels have been above 70 mg/L for many years. They can be dissolved by lowering SUA levels to at least 60 mg/L (treat-to-target - T2T - strategy). Once the crystals are dissolved, patients are no longer symptomatic and are considered to be in remission (treat-to-dissolve - T2D - strategy). The presence of crystals and their dissolution during treatment can be monitored by repeated ultrasound (US) scans of the feet and knees. The time required for complete dissolution varies from patient to patient. ReViGore40 is a cohort designed to i) determine the time to complete dissolution of urate deposits in joints when SUA levels are maintained below 40 mg/L, ii) determine the factors (clinical, biological, genetic) associated with the time required for complete dissolution of urate deposits within joints.
Eligibility
Inclusion Criteria5
- Age over 18 years
- Gout according to the ACR/Eular 2015 criteria
- SUA levels greater than 60 mg/L
- US score (MTP1s, knees) ≥2/24
- Informed consent Dated and signed voluntarily
Exclusion Criteria4
- Ongoing urate lowering therapy
- Severe and uncontrolled diseases such as cancer, cardiovascular or neurovegetative diseases
- Pregnant or breast-feeding women
- No affiliation to the French National Social Security System
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Interventions
\- Standard X-Rays: feet (Month 0)
\- Ultrasound (score 0-24): assessment for DC (Double Contour) sign (0-3), aggregates (0-3), tophi (0-3) at MTP1s (first metatarsophalangeal joints) and DC sign (0-3) at both knees, according to the OMERACT, every 6 months until complete dissolution of urate deposits.
DECT of feet: in tophaceous patients only (Month 0, Month 24)
DNA will be collected at Month 0
\- Serum will be collected at Month 0, Month 6, Month 12, Month 18, Month 24 , Month 36 and Month 48. For OMICs and epigenetic studies: Month 0, Month 6, Month 24 and Month 36.
Locations(1)
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NCT06669000