Uric Acid Target Achievement and Factors Associated with Treatment Outcomes in Gout: A Retrospective Study from a Tertiary Rheumatology Centre

Abstract

Gout is a chronic inflammatory arthritis caused by monosodium urate crystal deposition. Despite the availability of urate-lowering therapy (ULT), many patients fail to achieve target uric acid levels, leading to poor disease control. This study assessed uric acid target attainment and associated factors among gout patients in Latvia. A retrospective analysis was conducted on 503 patients diagnosed with gout at the ORTO Clinic (2013–2025). Data included demographics, ULT type (allopurinol or febuxostat), frequency of rheumatologist visits, and laboratory parameters at diagnosis and in 2023–2025. The uric acid target was defined as < 360 μ mol/l. Of 503 patients (93.2% men; mean age 51.6 years), 80.5% received allopurinol and 15.9% febuxostat. Only 22.5% achieved the target; 50.7% did not, and 26.8% had no recent uric acid testing. Target achievement was significantly associated with older age (p = 0.028), more frequent follow-up (p = 0.015), and higher vitamin D levels (p = 0.047). Uric acid correlated positively with LDL (r = 0.190) and total cholesterol (r = 0.200), and negatively with vitamin D (r = –0.193). Uric acid targets remain poorly achieved in routine practice. Improved patient monitoring, follow-up frequency, and attention to modifiable factors such as vitamin D status may enhance treatment outcomes.