Treat-to-Target Urate-Lowering Therapy Significantly Improves Quality of Life in Patients With Gout

In a post-hoc analysis of a large multicenter randomized trial published in Arthritis Care & Research, researchers found that treat-to-target urate-lowering therapy (ULT) for gout led to significant improvements in health-related quality of life (HRQoL)—especially in the areas of physical function, mobility, and pain. The results support the real-world value of protocolized ULT as a cornerstone in the long-term management of gout.

“While treat-to-target urate-lowering therapy (ULT) is endorsed as best practice in gout management, limited data exist on its impact on health-related quality of life (HRQoL),” the study authors explained. “We assessed the impact of treat-to-target ULT on HRQoL among participants receiving protocolized gout care, identifying factors associated with HRQoL and HRQoL change.”

The study analyzed 878 participants (98.9% male, mean age 62.4 years), pooling data from both allopurinol and febuxostat treatment arms over 72 weeks. HRQoL was assessed using the VR-12 and EQ-5D-3L instruments at four time points: baseline, 24 weeks, 48 weeks, and 72 weeks. Paired t-tests evaluated HRQoL changes, and regression analyses identified factors linked to baseline HRQoL and its change over time.

The findings revealed significant improvements in HRQoL by week 24, which were sustained through week 72 (p<0.001). The most prominent gains were seen in physical function, mobility, and pain domains. Patients with worse baseline HRQoL—particularly younger, non-White participants with tophi, higher serum urate levels, and more comorbidities—had the lowest starting scores. However, those with lower C-reactive protein levels and fewer comorbidities experienced the greatest improvements in quality of life.

“Treat-to-target ULT in gout is accompanied by HRQoL improvements evident by 24-weeks and sustained through 72-weeks,” the authors concluded. “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, Helget LN, 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). 2025 Aug 7. doi: 10.1002/acr.25618. Epub ahead of print. PMID: 40771143.