Gout Control Lowers Cardiovascular Events Save
A large target emulation trial suggests that gout patients prescribed urate-lowering treatment who achieve a serum urate level lower than 6 mg/dL significantly lower their risk of cardiovascular events.
Cohorts were derived from the Clinical Practice Research Datalink Aurum and included adult gout patients with a pretreatment serum urate level higher than 6 mg/dL, and were newly prescribed ULT. The primary outcome was first major adverse cardiovascular event within 5 years of first ULT prescription.
A total of 109 504 patients were included, with a mean age of 63 years and disease duration of 2.5 years. The T2T ULT arm was 27% of the cohort. Patients in the T2T ULT arm had a higher 5-year survival and lower risk of major adverse cardiovascular events (weighted HR, 0.91; 95% CI, 0.89-0.92) than those in the non–T2T ULT arm. Those who achieved a lower serum urate target of less than 5 mg/dL had a larger risk reduction (weighted HR, 0.77; 95% CI, 0.72-0.81).
T2T ULT patients had fewer gout flares.
Join The Discussion
Beg the question: who should be having their uric acid levels checked and how often? Patients with risk factors for MACE?
This JAMA article should get the attention of internists and the ACP who fail to recognize the importance of T2T and SUA monitoring. ACR and EULAR advocate monitoring SUA in everyone on ULT or problematic gout (of course pledging to a T2T strategY).. This CV and scary MACE risk should be easily endorsing for us rheumatologists.
Disclosures
The author has no conflicts of interest to disclose related to this subject
If you are a health practitioner, you may Login/Register to comment.
Due to the nature of these comment forums, only health practitioners are allowed to comment at this time.