Repeat Serum Urate Testing Not Superior to Single Measure for Gout Prediction

blood and serum in test tubes
blood and serum in test tubes
Researchers examine whether or not repeated serum urate testing produces a more accurate prediction of gout development.

The following article is a part of conference coverage from the American College of Rheumatology (ACR) Convergence 2021, being held virtually from November 3 to 10, 2021. The team at Rheumatology Advisor will be reporting on the latest news and research conducted by leading experts in rheumatology. Check back for more from the ACR Convergence 2021.


There is no added value of repeat serum urate testing over a single measurement to predict incident of gout over time, according to study results presented at the American College of Rheumatology (ACR) Convergence 2021, held virtually from November 3 to 10, 2021.

While elevated serum urate is a key risk factor for incident of gout, most patients with high serum urate levels will not develop the inflammatory arthritis. Furthermore, some patients with normal urate levels do develop gout. The objective of the current study was to determine whether repeat testing of serum urate is superior to a single test for predicting incident gout over time.

The researchers used data on 16,017 patients from Atherosclerosis Risk in Communities Study (ARIC), Coronary Artery Risk Development in Young Adults Study (CARDIA), and the original cohort of the Framingham Heart Study (FHS), (56% women; mean age, 49 years at baseline). With 2 serum urate measurements taken 3 to 5 years apart, followed by an assessment of gout incidence at 5 to 6 years after the second urate measure was taken, the researchers calculated the predictive ability of several models of serum urate testing on incident gout.

On average, the interval between the 2 serum urate measurements was 3.5 years, with data suggesting a small increase in the mean serum urate from 5.42 mg/dL in the first measurement to 5.71 mg/dL in the second measurement (P <.001).

There was a high correlation between the first and the second serum urate measures (P <.001) and there was no difference in the predictive ability of incident gout between various models of serum urate measurement, including using the first measure, the second measure, the average of both measures, and the highest of the measures.

“Repeat serum urate testing is not superior to a single measure of serum urate for prediction of incident gout over approximately [1] decade. These results may inform the design of longitudinal studies of incident gout, and clinical practice when providing advice to individuals about their risk of developing gout,” the researchers concluded.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.


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Stewart S, Phipps-Green A, Gamble G, et al. Is repeat serum urate testing superior to a single test to predict incident gout over time? 2021 American College of Rheumatology annual meeting: Abstract 1449. Presented November 8, 2021.