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Interpreting limits of past ULT trials A guiding doctrine of the ACP guideline was that retrospective studies and even RCTs that used the decline in serum urate level to a pre-stipulated target as an indirect, surrogate outcome, rather than demonstrating the improvement in a clinical outcome such as reduction in frequency of acute gout flares during the randomized phase of an RCT, were insufficient data for the standard of evidence-based guidelines defined by the Institute of Medicine (since renamed the National Academy of Medicine) 40
Similar observations on insulin resistance were made in diabetic mice [31, 46]
Rodriques, S
