Gout-Fracture Association Questioned

Findings from a new study suggest that gout may not actually be associated with an increased risk of fracture, despite previous evidence indicating otherwise.

For their study, the researchers evaluated 31,781 patients with incident gout between 1990 and 2004, along with 122,961 matched controls. Data were obtained from the Clinical Practice Research Datalink. Follow-up lasted until 2015.
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Cox regression models were used to calculate the absolute rate of fracture and hazard ratios (HRs). The impact of urate-lowering therapy on fracture was assessed among patients with gout.

Results of the study indicated that the absolute rate of fracture was similar in both gout patients and controls (53 vs 55 per 10,000 person-years; HR 0.97). Adjusting for age and sex did not alter these findings.

Furthermore, the researchers did not observe any statistically significant differences in fracture risk among patients who were prescribed urate-lowering therapy within 1 to 3 years post-gout diagnosis.

“Overall, gout was not associated with an increased risk of fracture,” the researchers concluded. “Urate-lowering drugs prescribed early during the course of disease had neither adverse nor beneficial effect on the long-term risk of fracture.”

—Christina Vogt

Reference:

Sultan AA, Whittle R, Muller S, et al. Risk of fragility fracture among patients with gout and the effect of urate-lowering therapy. CMAJ. 2018;190(19):E581-E587. https://doi.org/10.1503/cmaj.170806

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