Five years of treat-to-target gout therapy dissolves crystal deposits, nearly eliminates flares

The 5-year NOR-Gout study demonstrated that treat-to-target urate-lowering therapy (ULT) achieves sustained crystal dissolution and dramatic flare reduction in patients with gout. Among 163 patients followed through 5 years, 71% maintained serum urate <360 μmol/L, with ultrasound showing complete dissolution of double contour sign in 83% and tophi in 63%. Only 16% experienced flares in year 5, all with higher urate levels and persistent crystal deposits.

Clinical takeaway: Prioritize treat-to-target ULT and monitor serum urate consistently; long-term adherence can reverse crystal burden and improve outcomes.

Source:

Hammer HB, et al. (2025, November 20). Ann Rheum Dis. Ultrasound-detected crystal depositions and clinical flares dissolve during successful urate-lowering therapy: 5-year follow-up results from the treat-to-target NOR-Gout study. https://pubmed.ncbi.nlm.nih.gov/41271521/