Abstract: Objective To analyze the clinical characteristics and related factors of refractory gout and provide clinical experience for the treatment of refractory gout. Methods The clinical data of 148 patients with gout who were hospitalized in the department of rheumatology and immunology, Beijing Chaoyang Hospital, Capital Medical University from January 2016 to January 2020 were analyzed. The patients were divided into refractory gout group (44 cases) and non refractory gout group (104 cases). Results Among 148 gout patients ,29.72% of them were refractory gout patients. All gout patients did not strictly take a low purine diet, and 98.65% patients did not regularly take drugs to lower uric acid.There were statistically significant differences in age, body mass index (BMI), frequency of gout attack, number of joints involved, presence or absence of tophus and whether drinking alcohol between the two groups (P<0.05). There was no significant difference in smoking, family history of gout and gender between the two groups (P>0.05).The proportion of refractory gout group with hypertension, diabetes, coronary heart disease and renal insufficiency was higher than that of non refractory gout group (P<0.05). There were significant differences in creatinine, estimated glomerular filtration rate (eGFR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) between the two groups (P<0.05). Multivariate Logistic regression analysis showed that gout stones, serum uric acid, duration and involved joints were the relevant influencing factors of refractory gout (OR>1, P<0.05). Conclusion The patients in the refractory gout group often drank more alcohol, had higher ESR and CRP, and had more complications. Refractory gout is associated with higher serum uric acid, more joints involved, longer gout course, and the presence of gout stones.

Key words: gout, refractory, serum uric acid, treat to target, complications