No impact of serum uric acid on the outcome of recent-onset arthritis

摘要

Patients with rheumatoid arthritis (RA) have an almost twofold increase of cardiovascular (CV) mortality and morbidity as compared with the general population and it is thought that chronic inflammation contributes to this association. Serum uric acid (SUA) can contribute to low-grade inflammation via increased production of C reactive protein (CRP) and influences cytokine and superoxide production by circulating neutrophils. In RA, higher levels of SUA have been associated with a higher prevalence of CV disease. At the joint level, monosodium urate crystals can negatively influence local bone remodelling by excessive osteoclast formation and reduced osteoblast differentiation. Taking these data into account, we hypothesised that SUA levels in recent-onset arthritis are associated with a higher inflammatory state and thus might contribute to a more severe outcome, expressed by joint destruction and CV death rates in patients with RA and development of RA in patients with undifferentiated arthritis (UA).