Diet may be the most relevant feature for the success of urate lowering therapy in gout

Hyperuricemia and chronic deposition of monosodium urate crystals are the main cause of the gout. Urate lowering therapy (ULT) is the mainstay of chronic gout treatment. In this study, we evaluated demographic features and disease properties of the patients that would relate with the success of ULT. Sixty-six gout patients on pharmacologic ULT were enrolled in the study. Non-adherence to pharmacologic ULT was an exclusion criterium. Demographic and therapeutic features and co-illnesses and disease features of the patients were obtained during the study. Then, we compared these parameters between the patients with successful ULT and inadequate ULT. Adherence to diet was found different between the groups (OR, 7.00; CL%95 2.27 - 21.56). All other features including maximum allopurinol dosage were similar. We found that diet was the only factor that relate with success of ULT, while patients were on pharmacologic ULT. Non-adherence to both pharmacologic and non-pharmacologic measures is the main problem during ULT. Therefore, clinicians should emphasize the importance of all segments of ULT, including diet with informing patients during visits about the nature of disease and benefits of ULT.