Is it ever appropriate to reduce urate lowering therapy dose due to very low urate levels?

In my opinion, there are no known adverse outcomes related to very low serum urate levels. Suspected, but not proven, associations of dementia with sustained hypouricemia, have been used to create an impression that there may be one benefit of avoiding hypouricemia. There are multiple reasons for not reducing ULT in this situation in my practice:

1. This is an extremely rare situation. I define this as a serum urate of 3 mg or lower. In these rare instances, I will lower ULT by a slight amount, sa...