OBJECTIVE To determine the long-term use of and adherence to urate-lowering therapy (ULT), serum urate (SU) control, and self-reported flares in participants from a randomized controlled trial of allopurinol dose escalation, in order to achieve target SU concentration (< 0.36 mmol/L) in people with gout. METHODS For surviving study participants, ULT dispensing and SU testing within the preceding 12 months was obtained by medical record review. A phone interview was conducted to determine self-reported flares and adherence. RESULTS Over a mean follow-up of 6.5 (SD 2.5) years since enrollment, 60 out of 183 (33%) participants had died. Review of the 119 surviving participants showed that 98 (82%) were receiving allopurinol, 5 (4%) were receiving febuxostat, and 10 (8%) were not receiving ULT; for the remaining 6 (5.0%), ULT use could not be determined. In those receiving allopurinol, the mean dose was 28.1 (range -600 to 500) mg/day lower than at the last study visit; 49% were receiving the same dose, 18% were on a higher dose, and 33% were on a lower dose than at the last study visit. SU values were available for 86 of the 119 (72%) participants; 50 out of 86 (58%) participants had an SU concentration of < 0.36 mmol/L. Of the 89 participants who participated in the phone interview, 19 (21%) reported a gout flare in the preceding 12 months and 79 (89%) were receiving allopurinol; 71 (90%) of those receiving allopurinol reported 90% or greater adherence. CONCLUSION Most of the surviving participants in the allopurinol dose escalation study had good real-world persistence with allopurinol, remained at target SU, and had a low number of self-reported flares.

中文翻译：

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对痛风患者进行别嘌醇剂量递增以达到目标血清尿酸盐的随机对照试验的长期随访。

目的 确定长期使用和坚持降尿酸治疗 (ULT)、血清尿酸 (SU) 控制和来自别嘌醇剂量递增的随机对照试验的参与者自我报告的耀斑，以实现目标 SU痛风患者的浓度 (< 0.36 mmol/L)。方法 对于幸存的研究参与者，通过病历审查获得前 12 个月内的 ULT 分配和 SU 测试。进行电话采访以确定自我报告的耀斑和依从性。结果 自入组以来平均随访 6.5 (SD 2.5) 年，183 名参与者中有 60 名 (33%) 死亡。对 119 名幸存参与者的审查显示，98 名 (82%) 正在接受别嘌醇，5 名 (4%) 正在接受非布索坦，10 名 (8%) 未接受 ULT；对于其余 6 个 (5.0%)，无法确定 ULT 的使用。在接受别嘌醇治疗的患者中，平均剂量比上次研究访视时低 28.1（范围 -600 至 500）mg/天；与上次研究访视相比，49% 接受相同剂量，18% 接受更高剂量，33% 接受更低剂量。119 名参与者中有 86 名 (72%) 可以获得 SU 值；86 名参与者中有 50 名 (58%) 的 SU 浓度 < 0.36 mmol/L。在参加电话采访的 89 名参与者中，19 名 (21%) 报告在过去 12 个月内发作过痛风，79 名 (89%) 正在接受别嘌醇；71 (90%) 接受别嘌呤醇的患者报告说依从性达到 90% 或更高。结论 别嘌醇剂量递增研究中的大多数幸存参与者在现实世界中对别嘌醇具有良好的持久性，保持在目标 SU，并且自我报告的耀斑数量很少。