Treat-to-Target Urate-Lowering Therapy Improves Quality of Life in Gout
Treat-to-target urate-lowering therapy (ULT) was associated with significant improvements in health-related quality of life (HRQoL) over 72 weeks in patients with gout, according to a post hoc analysis of a randomized clinical trial. The findings provide patient-centered evidence supporting guideline-recommended, protocolized gout management.
Investigators pooled data from allopurinol and febuxostat arms of a 72-week randomized trial, including 878 participants. HRQoL was measured using the Veterans RAND-12 Item Health Survey and the EuroQol 5-Dimension 3-Level (EQ-5D-3L) at baseline and at 24, 48, and 72 weeks. Changes over time were evaluated alongside baseline predictors of HRQoL and factors associated with improvement.
Overall HRQoL scores improved significantly over 72 weeks, with gains apparent as early as 24 weeks. Improvements were most pronounced in domains related to physical function, mobility, and pain. The authors reported that “treat-to-target ULT in gout is accompanied by HRQoL improvements evident by 24 weeks and sustained through 72 weeks.”
Baseline HRQoL was lower in younger patients, non-White participants, those with tophi, higher serum urate levels, and greater comorbidity burden. In multivariable analyses, lower baseline C-reactive protein levels and fewer comorbid conditions were associated with greater improvements in HRQoL over time. Similar HRQoL changes were observed regardless of whether patients were assigned to allopurinol or febuxostat.
The authors concluded that HRQoL gains with treat-to-target ULT are “most prominent in the domains of physical function, mobility, and pain and are greatest in those with lower baseline levels of inflammation and comorbidity.”
Reference
Barry A, England BR, Sayles H, et al. Improvements in health-related quality of life with treat-to-target urate-lowering therapy in gout: a post hoc analysis of a randomized multicenter trial. Arthritis Care Res (Hoboken). Published online August 7, 2025. doi:10.1002/acr.25618
