Friday, 24 Jan 2020

You are here

Bariatric Surgery Thwarts Gout and Hyperuricemia

The rising incidence of gout has been directly linked to the obesity epidemic.  The influence of obesity on gout was further tested in a cohort study of obese patients undergoing bariatric surgery as part of the Swedish Obese Subjects (SOS) study.

This prospective intervention trial compared those receiving bariatric surgery (n= 1982) against obese controls (1999) receiving conventional treatment. None of the subjects had gout at baseline. The median followup for both groups was nearly 19 years. 

In the surgery group, 372 subjects underwent gastric banding, 1347 underwent vertical banded gastroplasty and 263 underwent gastric bypass.At the 2-year follow-up, BMI decreased by 23% in the surgery group, but no change in the control group.

Gout occurred more frequently in the control group (201) compared with the surgery group (138). The bariatric surgery had a significantly lower incidence of gout compared with usual care (adjusted HR 0.60, 95% CI 0.48 to 0.75, p<0.001). The number needed to be treated by bariatric surgery to prevent one gout event was 32

Figure 1

Similarly, the bariatric surgery cohort had a lower incidence of hyperuricaemia (adjusted HR 0.47, 95% CI 0.39 to 0.58, p<0.001) and the number of participants needed to be treated by bariatric surgery to prevent hyperuricaemia was 8 (95% CI 6 to 13).

The effect of bariatric surgery on gout incidence was not influenced by baseline risk factors, including body mass index.

The effectiveness of bariatric surgery in preventing gout and hyperuricaemia, underscores the value of weight reduction in gout prevention. 

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Diabetics using SGLT2 Inhibitors have a lower Gout Risk

Researchers from the Brigham and Women's Hospital have reported that adults with type 2 diabetes who were treated with SGLT2 inhibitors had a lower risk of gout compared to GLP1 agonist, suggesting that sodium–glucose cotransporter-2 inhibitors may reduce the risk for gout with type 2 diabetes mellitus (T2DM).

A Role for SGLT2 Inhibition in Gout?

The antidiabetic medication canagliflozin (Invokana) lowered serum urate and reduced the risk of gout flare in a post-hoc analysis of data from two large clinical trials.

Predicting Inpatient Gout Flares

Analysis of New Zealand hospitalized patients revals nine predictors of inpatient flare for people with comorbid gout.

This retrospective cohort study of hospitalised patients with comorbid gout included 625 hospitalised patients, 87 experienced inpatient gout flare.

There were 9 predictors of an inpatient gout flare:

Pegradicase+ImmTOR SEL-212 Shows Promising Results In Active Gout

Therapies targeting sUA accumulation or improving its excretion are widely used for treatment of symptoms and prevention of progression of gout for decades. Despite our best effort, there is still a significant amount of patients who remain symptomatic and/or experiences progressive joint damage and disability. Regardless of the cause, either its lack of compliance or poor tolerability, more effective treatments are needed.

PANLAR Ultrasound Study Group: Recommendations On Imaging Modalities In Gout

Gout is a systemic inflammatory disease with high potential for joint damage due to erosive changes and MSU deposits resulting in disability and chronic pain. Prompt diagnosis and effective treatment are key to better long term outcomes and decreased disability.