Recent Developments in Imaging and Biological Treatments for the Management of Refractory Gout
DOI:
https://doi.org/10.12775/JEHS.2025.85.66391Keywords
hyperuricemia, gout arthritis, DECTAbstract
Background
The deposition of monosodium urate crystals in the joints leads to gouty arthritis, characterised by chronic inflammation. Patients with tophaceous or treatment-resistant gout may encounter difficulties in achieving sustained disease control, although many individuals experience symptom relief with standard medication. Recent advancements in imaging, including dual-energy computed tomography (DECT) and ultrasound, have significantly improved the accuracy of detecting and monitoring urate deposits. Biologic and immunomodulatory approaches, such as uricase-based pharmaceuticals and IL-1β antagonists, are emerging as effective treatment alternatives for cases resistant to conventional therapy.
Aim of the study
The review seeks to emphasise recent advancements in the diagnosis and treatment of gout, concentrating on the clinical importance of cutting-edge imaging modalities and new biologic therapies in enhancing management and long-term results in refractory cases.
Materials and methods
This narrative review is based on a selective analysis of literature (2018–2025) sourced from PubMed and Scopus. Research focused on advanced imaging techniques (DECT, ultrasound) and innovative treatments for refractory gout, including immunomodulatory and biologic strategies, was emphasised. Recent advancements in diagnosis and therapy were evidenced by the integration of high-quality observational studies, randomised trials, and clinical recommendations.
Conclusions
Progress in pharmacogenetic profiling, biological therapy, and innovative urate-lowering medications is transforming the treatment of gout, particularly in refractory patients. Ultrasound and DECT enhance the accuracy of treatment, surveillance, and early detection. Incorporating these advancements into customised tactics may produce improved disability prevention and outcomes.
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