Monday, 10 Dec 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

Hepatic Safety of Urate Lowering Therapies in Gout

Lee and a group of Korean investigators have analyzed the comparative safety of allopurinol and febuxostat in a small cohort of gout patients with fatty liver disease (FLD) and found febuxostat had a lower risk for hepatotoxicity (defined as AST or ALT at least 3× the upper limit of normal) compared to allopurinol.

Treat-to-Target Strategy Cuts Mortality in Gout Patients

More intense treatment of gout with a treat-to-target strategy can reduce patients' risk for death, a Spanish researcher told a press conference Monday at the American College of Rheumatology annual meeting here.

TRIPLE Trial Results

Pegloticase has become an excellent option for management of patients with chronic refractory gout, although treatment may be limited by the development of anti-drug antibodies that lead to loss of serum urate (sUA) lowering effect.

Gout and the Social Determinants of Health

During a fascinating gout session on October 21, Hyon Choi presented an important paper (abstract 874) which used data from the Health Professionals Follow-up Study to try to understand the rapid increase in the incidence of gout in recent decades.

Nurse Led Gout Management Highly Effective

UK researchers have shown that nurse-led gout management, using a treat-to-target urate-lowering strategy, is efficacious and cost-effective compared with usual physicain care. The results are published in the recent Lancet edition.

Worldwide, gout management is suboptimal. In the UK only 40% of gout patients receive urate-lowering therapy, and fewer ever achieve a target serum urate (< 6mg/d) concentration.