Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: to assess whether changes in the clinical profile of gout are observed in a large cohort of gout patients over the last 20 years.
Methods: a total number of 904 patients have been prospectively included in a cohort of patients with gout from June 1992 to June 2012 with a gout-specific dataset (time from onset, joints involved, flares per year, X-ray involvement, presence of tophi, previous urate-lowering therapy-ULT, ongoing ULT, average serum urate while on therapy) in addition to general characteristics of subjects (age, gender, body mass index), and comorbidities (diabetes, chronic kidney disease, hypertension, hyperlipidemia, renal lithiasis, previous vascular events). For statistical analysis, patients have been stratified in two decades, from 1992 to 2002 (349 patients) and from 2002 to 2012 (555 patients).
Results:
as for the second decade, an statistically significant increase in age (57±12 vs. 61±13 years), in the number of flares (2.8±0.1 vs. 4.0±1.2 per patient-year), in BMI (27.5±3.2 vs. 28.2±4.2 kg/sqm) were observed. Serum urate at baseline and time from onset of gout to referral were not statistically different. Polyarticular – > 4 joints – involvement (29.8 vs. 39.5%) and presence of subcutaneous tophi (26.6 vs. 36.4%) were significantly more frequent in the second decade, although the percentage of patients naive to ULT (63.8 vs. 59.3%) or allergic to allopurinol (4.9 vs. 5.7%) were similar. Hypertension (33.4 vs. 51.9%), diuretic prescription (17.8 vs. 30.8%), and previous vascular events (20.7 vs. 31.8%) were signifficatly more common in the second decade. Although the mean clearance of creatinine were not statistically different, the percentage of patients with CKD stages 3-5 was close to significance (20.1 vs. 25.6%, p= 0.059.
Interestingly, while the mean baseline serum urate was numerically higher, the mean reduction and the percentage reduction from baseline were greater in the second decade (3.4 vs. 3.7 mg/dl and 38 vs. 45%, respectively), so that the percentage of patients averaging serum urate < 6 mg/dl while on follow-up remained pretty good (87 and 89%, respectively). This can reflect a trend to more intensive therapy due to more severe disease in the second decade.
Conclusion: the profile of patients with gout seems to have changed over the last two decades as they are older, more commonly hypertensive, on diuretics, with a previous vascular event, and they show more commonly tophaceous and polyarticular gout.
Disclosure:
F. Perez-Ruiz,
Menarini,
5,
Ardea Biosciences,
5,
Novartis Pharmaceutical Corporation,
5,
Savient,
5,
Menarini,
8,
Ardea Biosciences,
8,
Savient,
8,
Novartis Pharmaceutical Corporation,
8;
A. M. Herrero-Beites,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/changes-in-gout-patients-clinical-profile-in-the-last-two-decades/