Friday, 21 Sep 2018

You are here

Risk of Gout Onset and Flare Linked to Urate Levels

Serum uric acid (SUA) levels are clearly linked to gout. Researchers from Harvard have systemically reviewed the literature to quantify the risk of onset and flare with varying levels of SUA.

Literature review identified 8 eligible articles reporting gout incidence and 18 articles reporting recurrent gout rates in the context of SUA levels.

Gout incidence rates per 1000 person-years from population-based studies ranged from 0.8 (SUA ≤ 6 mg/dl) to 70.2 cases (SUA ≥ 10 mg/dl).

Recurrent gout risk in clinical cohorts ranged from 12% (SUA ≤ 6 mg/dl) to 61% (SUA ≥ 9 mg/dl) among those receiving urate-lowering therapy (ULT), and for those controlled with successful ULT, flare/recurrence rates ranged from 3.7% (SUA 6-7 mg/dl) to 61% (SUA > 9.3 mg/dl).

These data on the risks of higher SUA levels and gout underscores the need to treat to SUA targets as recommended by the American College of Rheumatology and the European League Against Rheumatism.

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

Add new comment

More Like This

Quarterly Canakinumab Reduces Gout Risk Without Affecting Uric Acid

The Annals of Internal Medicine reports that interleukin-1 (IL-1) inhibitor treatment is associated with a reduced risk of gout attacks - such are the findings of an anlysis of the CANTOS study previously reported at the Annual ACR 2017 meeting in Washington, DC. 

Usual Allopurinol Doses Insufficient in CKD Patients

Uric acid (sUA) control may be a challenge in patients with chronic kidney disease (CKD). A cohort study shows that conventional dosing recommendations for allopurinol are unlikely to reach target serum sUA goals.

Sleep Apnea Raises Gout Risk

Patients with obstructive sleep apnea were at increased risk for incident gout, particularly in the first years after the sleep apnea diagnosis, U.K. researchers reported.

In a large retrospective cohort study, the adjusted hazard ratio for a new gout diagnosis among individuals with sleep apnea was 1.42 (95% CI 1.29-1.56), according to Milica Blagojevic-Bucknall, PhD, of Keele University in Keele, England, and colleagues.

Adherence to Gout Therapies Painfully Low

A retrospective study of the large UK Clinical Practice Research Datalink assessed patient compliance in gout and found that adherence to allopurinol is poor, especially among females and younger patients and those with fewer comorbidities.

Not All Hyperuricemia Leads to Gout

Dalbeth and colleagues studied 4 large prospective cohorts and found that rising levels of serum uric acid (SUA) leads to a non-linear increased risk of incident gout, but only half of those with SUA ≥10mg/dL developed clinically evident gout.