According to international recommendations, urate lowering therapy (ULT), mainly the xanthine oxidase inhibitors (XOIs) allopurinol and febuxostat, should be prescribed lifelong in gout patients. However, this recommendation comes up against very poor adherence to ULT, since around half of patients stop their treatment at 5 years. Moreover, there is uncertainty about the cardiovascular tolerance of febuxostat taken over the long term. Finally, although XOIs are generally well tolerated, they can cause side effects and require regular biological monitoring. The hypothesis is that the risk of flares following withdrawal of ULT is very low in gout patients when urate store is depleted and repeated ultrasounds (US) do not demonstrate the reappearance of urate deposits.
Age ≥ 18 years
Gout, defined according to the 2015 ACR/EULAR classification criteria
No flares for at least 2 years
No tophi
Unstable systemic medical condition (e.g., New York Heart Association stage IV heart failure, recent myocardial infarction, advanced cancer)
History of allergy to allopurinol or febuxostat or one of the excipients
Association with azathioprine, mercaptopurine (cytostatics-antimetabolites)
Contraindications to experimental medicinal products or auxiliary medicinal products