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Gout is an independent risk factor for cardiovascular disease. Although urate-lowering therapy reduces gout flares, whether lowering serum urate improves cardiovascular outcomes remains uncertain.
In a cohort study of ≈100,000 adults with gout (78% male; mean baseline serum urate, 8.6 mg/dl), researchers compared the incidence of major adverse cardiovascular events in two groups who initiated urate-lowering therapy: patients who achieved serum urate below 6 mg/dl within 12 months and those who did not. Urate-lowering therapy was almost exclusively allopurinol (99%), and roughly 40% of patients also received nonsteroidal anti-inflammatory drugs or colchicine for flare prevention. Participants were followed for a maximum of 5 years (med…