In a cohort study emulating a target trial of 109,504 adults with gout newly prescribed urate-lowering therapy, achieving a serum urate level below 6 mg/dL within 12 months was associated with a lower 5-year risk of major adverse cardiovascular events compared with not achieving this target, with a weighted hazard ratio of 0.91 and greater relative risk reduction among patients at high cardiovascular risk; achieving a more stringent serum urate level below 5 mg/dL was linked to even larger risk reductions, and treat-to-target patients also experienced fewer gout flares, suggesting potential cardiovascular benefits of targeted urate lowering beyond musculoskeletal outcomes.

Source: JAMA Internal Medicine