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 vol...
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BMJ Publishing Group
2023-11-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/9/4/e003725.full |
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| author | Tristan Pascart Victor Laurent Charlotte Jauffret Aurore Pacaud Vincent Ducoulombier Julie Legrand Stéphane Verdun Laurène Norberciak Jean-François Budzik |
| author_facet | Tristan Pascart Victor Laurent Charlotte Jauffret Aurore Pacaud Vincent Ducoulombier Julie Legrand Stéphane Verdun Laurène Norberciak Jean-François Budzik |
| author_sort | Tristan Pascart |
| collection | DOAJ |
| 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 cm3 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 | Article |
| id | doaj-art-be76e2a820a648f3a94d4fbb478c1753 |
| institution | Kabale University |
| issn | 2056-5933 |
| language | English |
| publishDate | 2023-11-01 |
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| series | RMD Open |
| spelling | doaj-art-be76e2a820a648f3a94d4fbb478c17532025-02-07T08:50:14ZengBMJ Publishing GroupRMD Open2056-59332023-11-019410.1136/rmdopen-2023-003725Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with goutTristan Pascart0Victor Laurent1Charlotte Jauffret2Aurore Pacaud3Vincent Ducoulombier4Julie Legrand5Stéphane Verdun6Laurène Norberciak7Jean-François Budzik8Department of Rheumatology, Lille Catholic University, Saint-Philibert Hospital, Lomme, FranceDepartment of Rheumatology, Université Catholique de Lille, Lille, FranceRheumatology Department, Lille Catholic University, Saint Philibert Hospital, EA 7446 - ETHICS, Lille, FranceDepartment of Rheumatology, Université Catholique de Lille, Lille, FranceDepartment of Rheumatology, Université Catholique de Lille, Lille, FranceSaint-Philibert Hospital, Lille, FranceResearch Department, Université Catholique de Lille, Lille, FranceSaint-Philibert Hospital, Lille, FranceSaint-Philibert Hospital, Lille, FranceObjective 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 cm3 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.https://rmdopen.bmj.com/content/9/4/e003725.full |
| spellingShingle | Tristan Pascart Victor Laurent Charlotte Jauffret Aurore Pacaud Vincent Ducoulombier Julie Legrand Stéphane Verdun Laurène Norberciak Jean-François Budzik Factors influencing the kinetics of MSU crystal depletion measured with dual-energy CT in patients with gout RMD Open |
| 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 |
| url | https://rmdopen.bmj.com/content/9/4/e003725.full |
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