It is likely that the therapeutic niches for modified uricases in the treatment of gout will be for short term acceleration of tophus dissolution debulking in carefully selected patients with large tophus burdens and perhaps for more long term use in patients intolerant of or unresponsive to all other forms of urate lowering therapy doxycycline.world - doxycycline long term use The number of RCTs identified in our study is comparable to the number in a study conducted by Tsimberidou and colleagues that evaluated the long term marketing outcome of oncology drugs approved by the FDA without a randomized trial