JAMA Intern Med

Urate-lowering therapy may reduce MI, stroke risk in gout

January 27, 2026

In a large new‑user cohort study emulating a target trial, patients with gout who achieved serum urate <6 mg/dL within 12 months of starting urate‑lowering therapy had better cardiovascular outcomes than those who didn’t. Over 5 years, treat‑to‑target therapy was associated with 1.0% higher event‑free survival (95% confidence interval [CI], 0.5%–1.6%) and 9% lower risk of major adverse CV events (hazard ratio, 0.91; 95% CI, 0.89–0.92). Benefits were greater among patients at high or very high CV risk. Achieving urate <5 mg/dL conferred an even larger risk reduction.

Clinical takeaway: Titrating urate‑lowering therapy to achieve serum urate <6 mg/dL may reduce both gout flares and long‑term cardiovascular risk.

Source:

Cipolletta E, et al. (2026, January 26). JAMA Intern Med. Treat-to-Target Urate-Lowering Treatment and Cardiovascular Outcomes in Patients With Gout. https://pubmed.ncbi.nlm.nih.gov/41587055/