Controlling asymptomatic hyperuricemia may decrease the likelihood of gout flares, according to an analysis of real-world data from Japan.

A retrospective study of 19,261 patients with serum uric acid levels of 8.0 mg/dL or higher found that patients with either gout or asymptomatic hyperuricemia who achieved levels of 6.0 mg/dL or lower with urate-lowering therapy (ULT) had fewer occurrences of gout flare compared with those whose serum uric acid level remained above 6.0 mg/dL, Ruriko Koto, MMSc, of Teijin Pharma Limited in Tokyo, and colleagues reported in Annals of the Rheumatic Diseases. Patients with asymptomatic hyperuricemia and those with gout who were on ULT and had serum uric acid levels of 6.0 mg/dL or less but higher than 5.0 mg/dL had a significant 55% and 35% decreased risk for gout flare, respectively, compared with untreated patients whose serum uric acid levels were 8.0 mg/dL or higher.

The investigators identified study patients using the JMDC Claims Database. The database contains information from health insurance associations that include only limited data from individuals aged 65 years or older and no data from those aged 75 years or older, “so our findings cannot be generalized to the entire Japanese population,” Koto and colleagues noted. In addition, the study was limited to annual medical check-up data, so serum uric acid was measured only once a year in most cases “and subjects might not have taken their ULT or other drugs on the day of the check-up.”

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Disclosure: This research was supported by Teijin Pharma Limited. Please see the original reference for a full list of disclosures.


Koto R, Nakajima A, Horiuchi H, Yamanaka H. Serum uric acid for prevention of gout flare in patients with asymptomatic hyperuricaemia: a retrospective cohort study of health insurance claims and medical check-up data in Japan. Ann Rheum Dis. Published online June 22, 2021. doi:10.1136/annrheumdis-2021-220439