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Withdrawal of longterm antihyperuricemic therapy in tophaceous gout
M F van Lieshout-Zuidema1, F C Breedveld
1Department of Rheumatology, University Hospital, Leiden, The Netherlands.
Objective:
To determine the effect of withdrawal of antihyperuricemic therapy on the recurrence of tophi and acute arthritis.
Methods:
We performed a retrospective investigation of 21 patients with tophaceous gout who stopped therapy because they had no arthritis for years, and on examination tophi had disappeared.
Results:
Nine patients (43%) had a recurrence of tophi after an average period of 39.6 months (range 4-107 months). Seventeen patients (81%) had attacks of acute arthritis, 6 patients within 6 months. During a mean period of drug discontinuation of 37.6 months no increase in serum creatinine or deterioration in joint function was observed.
Conclusion:
Based on our data we conclude that intermittent usage of antihyperuricemic drugs will, after a variable period, result in the frequent recurrence of acute arthritis and tophi.