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Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout
OBJECTIVE: To examine factors influencing the kinetics of monosodium urate (MSU) crystal dissolution measured with dual-energy computed tomography (DECT) during follow-up of patients with gout. METHODS: Patients with a diagnosis of gout with baseline knees and feet DECT scans exhibiting MSU crystal...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632919/ https://www.ncbi.nlm.nih.gov/pubmed/37940341 http://dx.doi.org/10.1136/rmdopen-2023-003725 |
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author | Laurent, Victor Jauffret, Charlotte Pacaud, Aurore Ducoulombier, Vincent Legrand, Julie Verdun, Stéphane Norberciak, Laurène Budzik, Jean-François Pascart, Tristan |
author_facet | Laurent, Victor Jauffret, Charlotte Pacaud, Aurore Ducoulombier, Vincent Legrand, Julie Verdun, Stéphane Norberciak, Laurène Budzik, Jean-François Pascart, Tristan |
author_sort | Laurent, Victor |
collection | PubMed |
description | OBJECTIVE: To examine factors influencing the kinetics of monosodium urate (MSU) crystal dissolution measured with dual-energy computed tomography (DECT) during follow-up of patients with gout. METHODS: Patients with a diagnosis of gout with baseline knees and feet DECT scans exhibiting MSU crystal volumes ≥0.1 cm(3) and at least one follow-up DECT were included. Spearman’s correlation coefficient was used to search for association between change from baseline MSU crystal volume at 6, 12, 18 and 24 months and serum urate (SU) level. Associations between percentage change from the baseline volume of MSU crystal deposits and explanatory variables were assessed using linear mixed models. RESULTS: Sixty-two patients (age 67.3±12.8 years; 53 (85%) males) cumulating 104 follow-up DECT scans were included. Overall, SU target levels (<6.0 and <5.0 mg/dL) were achieved by 48 (77%) and 36 (58%) patients, respectively. There was a good correlation (r=0.66; p<0.0001) observed between SU level and percentage change in MSU crystal volume. The median decrease from baseline MSU crystal volume was greater in patients reaching the <5.0 mg/dL SU target than in those reaching ≥5.0 SU <6.0 mg/dL: −85% (95% CI: −94% to −72%) versus −40% (−57% to −22%; p<0.05) at 12 months. In multivariable analysis, time (in days) with a multilevel coefficient of −0.06 (95% CI: −0.08 to −0.03, p<0.001), hypertension (coefficient: 41.87, 95% CI: 16.38 to 67.18, p<0.01) and SU level <5.0 mg/dL (coefficient: −39.46, 95% CI: −70.93 to −8.34, p=0.02) were the only variables significantly associated with MSU crystal volume change. CONCLUSION: In patients with DECT-measured MSU crystal deposition, reaching the <5.0 mg/dL SU target provides more extensive and rapid crystal dissolution than reaching the <6.0 mg/dL SU target. |
format | Online Article Text |
id | pubmed-10632919 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-106329192023-11-10 Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout Laurent, Victor Jauffret, Charlotte Pacaud, Aurore Ducoulombier, Vincent Legrand, Julie Verdun, Stéphane Norberciak, Laurène Budzik, Jean-François Pascart, Tristan RMD Open Crystal Arthropathies OBJECTIVE: To examine factors influencing the kinetics of monosodium urate (MSU) crystal dissolution measured with dual-energy computed tomography (DECT) during follow-up of patients with gout. METHODS: Patients with a diagnosis of gout with baseline knees and feet DECT scans exhibiting MSU crystal volumes ≥0.1 cm(3) and at least one follow-up DECT were included. Spearman’s correlation coefficient was used to search for association between change from baseline MSU crystal volume at 6, 12, 18 and 24 months and serum urate (SU) level. Associations between percentage change from the baseline volume of MSU crystal deposits and explanatory variables were assessed using linear mixed models. RESULTS: Sixty-two patients (age 67.3±12.8 years; 53 (85%) males) cumulating 104 follow-up DECT scans were included. Overall, SU target levels (<6.0 and <5.0 mg/dL) were achieved by 48 (77%) and 36 (58%) patients, respectively. There was a good correlation (r=0.66; p<0.0001) observed between SU level and percentage change in MSU crystal volume. The median decrease from baseline MSU crystal volume was greater in patients reaching the <5.0 mg/dL SU target than in those reaching ≥5.0 SU <6.0 mg/dL: −85% (95% CI: −94% to −72%) versus −40% (−57% to −22%; p<0.05) at 12 months. In multivariable analysis, time (in days) with a multilevel coefficient of −0.06 (95% CI: −0.08 to −0.03, p<0.001), hypertension (coefficient: 41.87, 95% CI: 16.38 to 67.18, p<0.01) and SU level <5.0 mg/dL (coefficient: −39.46, 95% CI: −70.93 to −8.34, p=0.02) were the only variables significantly associated with MSU crystal volume change. CONCLUSION: In patients with DECT-measured MSU crystal deposition, reaching the <5.0 mg/dL SU target provides more extensive and rapid crystal dissolution than reaching the <6.0 mg/dL SU target. BMJ Publishing Group 2023-11-08 /pmc/articles/PMC10632919/ /pubmed/37940341 http://dx.doi.org/10.1136/rmdopen-2023-003725 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) . |
spellingShingle | Crystal Arthropathies Laurent, Victor Jauffret, Charlotte Pacaud, Aurore Ducoulombier, Vincent Legrand, Julie Verdun, Stéphane Norberciak, Laurène Budzik, Jean-François Pascart, Tristan Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout |
title | Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout |
title_full | Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout |
title_fullStr | Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout |
title_full_unstemmed | Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout |
title_short | Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout |
title_sort | factors influencing the kinetics of msu crystal depletion measured with dual-energy ct in patients with gout |
topic | Crystal Arthropathies |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10632919/ https://www.ncbi.nlm.nih.gov/pubmed/37940341 http://dx.doi.org/10.1136/rmdopen-2023-003725 |
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