#3-75E. Beyond the Flare: Five-Year Crystal Dissolution in Gout (ARD, 2026)

Can long-term urate control truly eradicate joint crystals in gout? Today, we delve into the 5-year follow-up results of the treat-to-target NOR-Gout study. This prospective observational study tracked patients undergoing urate-lowering therapy, demonstrating that sustained reduction in serum uric acid leads to a continuous, marked decrease in ultrasound-detected crystal depositions and clinical flares. The most groundbreaking clinical finding is that long-term low uric acid maintenance not only dissolves double contour signs and tophi in the vast majority of patients, but also that this complete dissolution can be reliably monitored simply by examining the bilateral first metatarsophalangeal (MTP1) joints. While we must critically note that this is a single-center observational study without randomization—which inherently limits its generalizability and causal inferences—its clinical implications remain profound. For practicing physicians, this evidence reinforces the critical need for strict treat-to-target strategies and offers a highly feasible, simplified ultrasound approach for long-term patient monitoring and adherence counseling in daily clinical practice.

Citation: Hammer HB, Karoliussen L, Terslev L, Haavardsholm EA, Uhlig T. Ultrasound-detected crystal depositions and clinical flares dissolve during successful urate-lowering therapy: 5-year follow-up results from the treat-to-target NOR-Gout study. Annals of the Rheumatic Diseases. 2026. DOI: 10.1016/j.ard.2025.10.029

Disclaimer: This audio summary is based on personal interpretation and does not guarantee the exact content of the original paper. Please refer to the original article for details.