Most patients with gout experienced at least one flare after an initial diagnosis, with joint involvement other than the first metatarsophalangeal joint being a significant predictor, according to research presented at the annual congress of the European League Against Rheumatology in Madrid.
“Because patients often think that a gout flare-up means their medications are not working, they may stop medications like allopurinol,” researcher Eric L. Matteson, MD, rheumatology chair at Mayo Clinic, Rochester, Minn., said in a press release. “It is especially important for these patients to continue taking gout medication to prevent flare-ups.”
Eric L. Matteson
Matteson and colleagues studied a population-based cohort of 46 patients (70% men) with incident gout (mean age at gout onset, 66 years) diagnosed according to New York, Rome or ACR preliminary criteria. Community medical records were used to follow patients longitudinally until death, migration or July 1, 2012, with a mean follow-up of 12.9 years. Risk factors of subsequent flares were assessed through a conditional frailty model.
The most common form of joint involvement at disease onset was isolated podagra (72%). Mean serum uric acid level was 8.1 mg/dL. At least one subsequent flare was developed by 28 patients (61%); 101 subsequent flares occurred during follow-up. Subsequent flare risk was not significantly predicted by age and gender.
“Patients with the highest risk of subsequent flares had an initial joint involvement other than the first metatarsophalangeal joint (OR=3.9; 95% CI, 1.03-14.77) and a high serum uric acid level at baseline (OR=1.69; 95% CI, 1.26-2.27),” the researchers reported.
For more information:
Bongartz T. SAT0539: The Risk of Future Attacks in Patients with Incident Gout: A Population-Based Study. Presented at: EULAR 2013; June 12-15, Madrid.