The prevalence of both hyperuricemia and gout has risen in the last decades in developed countries and therefore the burden of gout has increased. The association of hyperuricemia and gout with cardiovascular outcomes and the opportunity of further benefits of intervention on hyperuricemia have been recently highlighted in the literature. Imaging techniques have proven to be useful for detection of urate deposition, even prior to the first clinical symptoms, enabling the evaluation of the extent of deposition and providing objective measurement of crystal depletion during urate-lowering treatment. Treating to target is increasingly used as the approach to treatment of diverse diseases. Therefore, different targets have been recommended for different stages of the burden of disease and for different stages of treatment. The final strategic target, to which any effort should be taken into consideration, is to completely dissolve urate crystals in tissues and therefore avoid further symptoms and structural damage of involved musculoskeletal structures. In summary, evidence suggest that an early approach to the treatment of gout and associated comorbidities is advisable, that new imaging techniques may help to evaluate both the burden of deposition and response to urate-lowering treatment in selected patients, and finally that the final strategic objective of healthcare for patients with gout is to completely resolve urate crystal deposits.
CHARLES Y. C. PAK, KHASHAYAR SAKHAEE, and CINDY FULLER. Successful management of uric acid nephrolithiasis withpotassium citrate. Section on Mineral Metabolism, Department of Internal Medicine, Southwestern Medical School, University of Texas Health Science Centerat Dallas, TX 75235. Kidney international, Vol. 30 (1986), pp. 422—428
W Mohr 1 , E Görz. [Mixed tophi. Calcium pyrophosphate dihydrate crystals in gout tophi]. Z Rheumatol. 2000 Aug;59(4):240-4.doi: 10.1007/s003930070066. PMID: 11013985. DOI: 10.1007/s003930070066
Mariano Andres,1Marıa-Amparo Quintanilla,2Francisca Sivera,2JoseSanchez-Paya,3Eliseo Pascual,4Paloma Vela,4and Juan-Miguel Ruiz-Nodar3. Silent Monosodium Urate Crystal Deposits Are AssociatedWith Severe Coronary Calcification inAsymptomatic Hyperuricemia. An Exploratory Study. ARTHRITIS & RHEUMATOLOGY Vol. 68, No. 6, June 2016, pp 1531–1539DOI 10.1002/art.39581
R Cinia, D Chindamob, M Catenacciob, S Lorenzinib, E Selvib, F Neruccib, M P Picchib, G Bertib, R Marcolongob. Dissolution of calcium pyrophosphate crystals by polyphosphates: an in vitro and ex vivo study. http://dx.doi.org/10.1136/ard.60.10.962
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