Patients in this cohort had a diagnosis of tophaceous gout, had at least 2 visits with a Cleveland Clinic rheumatologist, and were prescribed a uric acid-lowering agent (allopurinol, febuxostat, probenecid, or lesinurad). The recommended target uric acid level was ≤ 5.0 mg/dL. Two 6-year periods were compared: 2001–2007 and 2014–2020. The percentage of patients who achieved a uric acid level of ≤ 5.0 mg/dL increased from 17.7% in 2001–2007 to 76.5% in 2014–2020. The percentage of patients who achieved a uric acid level of < 6.0 mg/dL increased from 39.2% in 2001–2007 to 90.5% in 2014–2020. In the period 2001–2007, 45.1% of patients did not achieve a uric acid level < 7.0 mg/dL; in the period 2014–2020, fewer patients (5.7%) did not achieve a uric acid level < 7.0 mg/dL.
The percentage of patients who achieved acceptable uric acid levels increased in the period 2014–2020 vs. 2001-2007. Improvement in the percentage of patients who achieved target uric acid levels in 2014–2020 may be related to the release of febuxostat in 2009 and pegloticase in 2010, as well as more emphasis on treatment to target.