NIH-funded research U01 cooperative agreement

Targeting low blood uric acid versus treating gout flares for adults with gout

Official title: Treat-to-Target Serum Urate versus Treat-to-Avoid Symptoms in Gout: A Randomized Controlled Trial (TRUST)

Funded at Massachusetts General Hospital · NIH-11171432 · Data updated 2026-11-12

This compares keeping blood uric acid below a set level versus treating gout flares only, for adults living with gout.

More Randomized Controlled Trial research and trials

Quick facts

Grant typeU01 cooperative agreement
Study typeNIH-funded research
Funding institutionMassachusetts General Hospital
NIH-funded
Lab location1 site (Boston, United States)
Project startSeptember 1, 2023
Project endJuly 31, 2028
Funding year2025
Award (this year)$1,812,686
NIH project number5U01AR080985-03
Project IDNIH-11171432 on NIH RePORTER

Who could benefit from this research

Could help

Adults (age 21 and older) with a diagnosis of gout who can take urate‑lowering medication, have regular blood testing, and attend follow‑up visits are ideal candidates.

Less likely to help

People without gout, those unwilling or unable to take urate‑lowering drugs or have regular blood tests, or those with contraindications to study treatments may not receive benefit from participation.

What this research studies

If you join, adults with gout will be randomly assigned to either care that aims to keep blood uric acid under a target using regular testing and urate‑lowering medicines, or to care that focuses on treating flare symptoms as they occur. Clinicians at participating centers (primary care and rheumatology) will manage medications, collect blood tests, and record gout flares and other health events. The trial will follow participants over time with clinic visits and medical record review to track gout attacks, kidney function, diabetes control, cardiovascular events, and quality of life. Results are intended to give clear, practical guidance for routine gout care.

Why it matters

Potential benefit: If successful, this could show whether aiming for a low uric acid level prevents gout attacks and lowers risks of kidney, metabolic, or heart complications.

How similar studies have gone: Guidelines recommend lowering serum urate but high‑quality randomized trials directly comparing treat‑to‑target versus symptom‑based care are lacking, so this comparison remains unproven.

Where this research is happening

  • Massachusetts General Hospital
    Boston, United States
    Active

Researchers

  • Principal investigator: Choi, Hyon K — Massachusetts General Hospital
  • Study coordinator: Choi, Hyon K

Related research

Other NIH-funded projects on the same topics.

  • Treat-to-Target Urate in Gout: A New Approach for Better Pain and Health

    A large clinical trial tests whether aiming for a specific uric acid level in gout patients improves symptoms and health outcomes compared with avoiding symptoms.

    NIH research Massachusetts General Hospital · Boston, United States · NIH-11416296

  • SGLT2 inhibitors for gout care in adults with diabetes

    A randomized trial is testing whether an SGLT2 inhibitor can help reduce gout flares and improve heart and kidney health in adults with type 2 diabetes.

    NIH research Massachusetts General Hospital · Boston, United States · NIH-11358299

  • Using SGLT2 inhibitors to improve gout care

    This study is looking at whether a type of medication called SGLT2 inhibitors can help people with gout feel better and reduce their risk of heart problems, and it’s for adults who experience gout flare-ups.

    NIH research Massachusetts General Hospital · Boston, United States · NIH-11047879

  • Comparing treatment strategies for managing gout symptoms and serum urate levels

    This study is looking at two ways to help people with gout: one that tries to lower uric acid levels in the blood and another that focuses on easing pain and other symptoms, so if you have gout, you can help us find out which method works better for your health!

    NIH research Massachusetts General Hospital · Boston, United States · NIH-10917026

  • Cognitive behavioral therapy and trazodone for insomnia phenotypes with high blood pressure

    A clinical study tests how CBT-I and the sleep drug trazodone work for adults with insomnia and high blood pressure, focusing on a specific sleep duration pattern.

    NIH research Pennsylvania State Univ Hershey Med Ctr · Hershey, United States · NIH-11635771

  • Shorter antifungal treatment for kids with candidemia

    A multi-center pediatric trial tests whether a shorter, 7 extra days of antifungal therapy after an initial 7 days is just as good as the standard 14-day approach for kids with candidemia who are improving on echinocandin therapy.

    NIH research Arkansas Children's Hospital Res Inst · Little Rock, United States · NIH-11606539

About this research

  1. This is an active NIH-funded research project — typically early-stage science, not a clinical trial accepting patient enrollment.
  2. Some NIH-funded labs run parallel clinical studies or seek volunteers for related work. To check, contact the principal investigator or institution listed above.
  3. For full project details, budget, and progress reports, visit the official NIH RePORTER page.
Last reviewed 2026-11-14 by the Find a Trial editorial team. Information on this page is for educational purposes and is not medical advice. Always consult qualified healthcare professionals about clinical trial participation.