To determine the effect of withdrawal of antihyperuricemic therapy on the recurrence of tophi and acute arthritis.
We performed a retrospective investigation of 21 patients with tophaceous gout who stopped therapy because they had no arthritis for years, and on examination tophi had disappeared.
Nine patients (43%) had a recurrence of tophi after an average period of 39.6 months (range 4-107 months). Seventeen patients (81%) had attacks of acute arthritis, 6 patients within 6 months. During a mean period of drug discontinuation of 37.6 months no increase in serum creatinine or deterioration in joint function was observed.
Based on our data we conclude that intermittent usage of antihyperuricemic drugs will, after a variable period, result in the frequent recurrence of acute arthritis and tophi.