Thursday, 21 Mar 2019

You are here

Sons of Gout Study

The genetics and heritability of gout has suggested a higher risk in certain families.  A UK cohort study examined the prevalence of gout and monosodium urate (MSU) crystal deposition among those at risk (sons of gout patients) for gout and found a high incidence of hyperuricemia and MSU crystal deposition.

The sons of patients with gout (n=131) were contacted, screened by telephone and subsequently had a study-visit evaluation for blood and urine collection, and musculoskeletal ultrasonography (MSK US).

Amongst 131 sons of gout, 64.1% had serum urate (SU) ≥6 mg/dl, and 30% had MSK US evidence of either a double contour sign (DCS) or intra-articular aggregates/tophi in ≥1 joint.

All subjects with MSU deposition had involvement of 1st metatarsophalangeal joint and a subset (21%) had intra-tendinous aggregates.

For those with SU ≤5 mg/dl no MSU depositoin was found; but those 24% of those with SU between 5-6 mg/dl had ultrasonographic MSU deposition.

For every SU increased of 1 mg/dl, there was a 61% increase in the odds of finding MSU crystal deposition.

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

Add new comment

More Like This

Ironwood Retreats from the US Gout Market

Ironwood Pharmaceuticals discontinued the marketing and sales of both lesinurad (Zurampic) the combination drug of lesinurad and allopurinol (Duzallo) in the United States effective February 1, 2019. In addition the Duzallo and Zurampic Patient Savings Program were also discontinued on December 31, 2018.

The company stated that this was a financial decision unrelated to the efficacy or safety of lesinurad.

Allopurinol Reduces Cardiovascular Outcomes in Diabetes

A Canadian study has shown that elderly diabetics who take allopurinol have a significant reduction in cardiovascular outcomes.  

Hyperuricemia has been shown to be a biomarker for cardiovascular outcomes in multiple disorders. These investigators studied the effect of allopurinol and mortality on CV outcomes in a population-based retrospective cohort study from Ontario, Canada.

FDA Slaps a Boxed Warning on Febuxostat for CV Risk

The U.S. Food and Drug Administration (FDA) has reviewed data from the Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) trial and concluded there is an increased risk of death with Uloric (febuxostat) compared with allopurinol, and has added this as a boxed warning to the drug’s product label.

U.S. Gout Rates Remain Steady, but Substantial

Using data from 5,467 adults in the US in the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2016, researchers found that the prevalence of gout and hyperuricemia has remained at 3.9%, having doubled from the 1960s to the 1990s, corresponding to an estimated 9.2 million adults with gout in 2015-2016.

Febuxostat Gets Reprieve from FDA Advisory Panel

On January 11, 2019 the FDA convened two advisory panels (the Arthritis Advisory Committee [AAC] and the Drug Safety and Risk Management Advisory Committee [DSaRM]) to consider the cardiovascular safety of febuxostat (Uloric) based on the 2018 “Cardiovascular Safety of Febuxostat and Allopurinol in Patients with Gout and Cardiovascular Morbidities (CARES) study. 

The Vote