COVID-19 Vaccination and Gout Flares

Patients with previously infrequent flares appeared to experience an increase in early gout flares after receiving their SARS-CoV-2 vaccination, according to the results of a prospective cohort study published in Arthritis Care & Research.

“Gout flares occurred mostly within the first 4 weeks after the first injection of vaccine and dropped to the same level as in the unvaccinated participants at 8-12 weeks,” the research paper read.

Of the 530 enrolled participants, 308 (58.1%) had infrequent flares defined as less than or equal to 1 flare, and 222 (41.9%) had frequent flares defined as more than or equal to 2 flares. At the end of 12 weeks, the team assessed the primary outcomes as “the incidence of gout flares based on baseline burden of flare frequency.”

The results found 36.8% of all participants (17.9% with infrequent flares and 63.1% with frequent flares) experienced a gout flare. COVID-19 vaccination appeared to have a 2.82-fold increase (95% CI, 1.50-5.30) in cumulative flare incidence among the infrequent flare group. The participants in the frequent flare group did not experience any such notable increase.

In the infrequent flare group, the incidence of flares toward the end of observation period decreased significantly after vaccination (4.3% vs 12.0%; P=.017)

Baseline serum urate levels were associated with flare risk in the frequent flare group (OR, 1.23; 95% CI, 1.05-1.45; P=.012).

Reference:
He Y, Xue X, Dalbeth N et al. COVID-19 vaccination and gout flare risk in patients with infrequent or frequent flares: A prospective cohort study. Arthritis Care Res. 2023. DOI: https://doi.org/10.1002/acr.25215