Treat-to-target urate-lowering therapy (ULT) is considered best practice in gout management, yet its impact on health-related quality of life (HRQoL) remains unclear. A post-hoc analysis of a randomized, multicenter trial by Austin Barry, MD, and colleagues investigated how protocolized treat-to-target ULT affects HRQoL and explored factors linked to both baseline HRQoL and subsequent changes.
The analysis pooled data from the allopurinol and febuxostat arms of a 72-week randomized trial. Researchers assessed HRQoL at baseline and at 24, 48, and 72 weeks using the VR-12 and EQ-5D-3L questionnaires. They evaluated baseline HRQoL predictors with multivariable linear regression and analyzed factors driving HRQoL changes over time using general estimating equations.
Of 878 participants, 98.9% were male, 67.4% self-reported as White, and the mean age was 62.4 years. HRQoL improved by 24 weeks and continued to improve significantly through 72 weeks (P<0.001), with the largest gains in physical function, mobility, and pain. Participants who were younger, non-White, or had tophi, higher serum urate, and more comorbidities scored lower at baseline. Lower baseline C-reactive protein and fewer comorbidities predicted greater HRQoL improvements during follow-up.