ACR Meeting Abstracts

ACR Meeting Abstracts

  • Meetings
    • ACR Convergence 2024
    • ACR Convergence 2023
    • 2023 ACR/ARP PRSYM
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • ACR Meetings

Abstract Number: 869

Failure to Reach Serum Urate Target Is Associated with Elevated Mortality in Gout

Fernando Perez-Ruiz1,2,3, Pascal Richette4,5, Austin Stack6, Ravichandra Karra Gurunath7, MARIA JESUS GARCIA DE YEBENES Y PROUS8 and Loreto Carmona9, 1Rheumatology Division, Hospital Universitario Cruces, Baracaldo, Spain, 2University of the Basque Country (UPV/EHU), Bilbao, Spain, 3BioCruces Health Research Institute, Barakaldo, Spain, 4Lariboisière Hospital, Lariboisière, University of Paris 7, Paris, France, 5Rheumatology, Université Paris Diderot, Paris, France, 6Nephrology, University Hospital Limerick & Health Research Institute,University of Limerick, Limerick, Ireland, 7Grünenthal GmbH, Aachen, Germany, 8Institute for Musculoskeletal Health, Madrid, Spain, 9Instituto de Salud Musculoesquelética (InMusc), Madrid, Spain

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: gout, morbidity and mortality and treatment

  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print
Session Information

Date: Sunday, October 21, 2018

Title: 3S083 ACR Abstract: Metabolic & Crystal Arthropathies: Comorbidities & Outcomes (869–874)

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Gout is associated with an increased risk of cardiovascular events and death. It has been shown that both overall and risk of death are associated with increasing gout severity, as reflected by the number of tophi. It remains to be proven whether better control of gout through lowering of serum uric acid (sUA) confers a survival advantage. To determine the impact of achieving sUA less than 6 mg/dl (vs greater) on mortality risk among gout patients.

Methods: Analysis of data from a prospective follow-up cohort (1992 to 2017) of patients attending a gout clinic (85% of patients with microscope or ultrasound diagnosis) and with at least one follow-up visit. Mortality was confirmed from medical records, patients’ families, or local death registries if needed. sUA levels were monitored during follow-up and the average sUA until sUA was stable was used as the primary exposure dichotomized as < 6 mg/dl (versus > 6 mg/dl). Descriptive variables and potential confounders included: age, gender, body mass index, previous treatment with urate-lowering drugs (ULDs), number of joints affected at entry, presence of subcutaneous tophi, radiographic evidence of articular damage, number of gout flares in the year preceding evaluation, previous diagnosis of cardiovascular (CV) disease, loop diuretic use, alcohol intake, diabetes, hypertension, hyperlipidemia, and renal function impairment. In addition, the Kaiser Permanente stratification of comorbidity was further used to risk stratify patients from low to high risk of death. Univariate and multivariate Cox proportional hazards models were used to determine mortality risks expressed a hazard ratios (HR) and 95% Confidence Intervals (CI).

Results: The study cohort included 1,193 patients (92% men, mean age 60, 6.8 years disease duration, with an average of 3 to 4 flares in the previous year). Mean follow-up was 48 (median 30, IQR 12-66), with 4,830 patient-year observation. Mean sUA at baseline was 9.1 mg/dl and 16.3% of the patients maintained sUA levels ≥6 mg/dl despite treatment. A total of 158 deaths occurred (13% overall mortality), with loss to follow-up in 286 cases (24%). Overall crude mortality rate was 32.7 per 1,000 patient-years, (95% CI: 28.0-38.2) and was significantly higher for patients with sUA ≥ 6 mg/dl, 80.9 per 1, 000 person years (95% CI 59.4-110.3) compared to patients with sUA <6 mg/dl, 25.7 per 1,000 person-years (95% CI: 21.3-30.9). With adjustment for age, sex, previous CV events, and baseline sUA concentration, a sUA ≥ 6 mg/dl was associated with a HR of 2.39 (1.64 – 3.50).

Conclusion: Failure to reach a target sUA level of 6 mg/dl is an independent predictor of mortality in gout patients. Control of gout with achievement of sUA target <6 mg/dl should be considered in order to improve patient survival.


Disclosure: F. Perez-Ruiz, Amgen Inc., 5, 8,Grünenthal, 5, 8,Menarini, 5, 8,Asociación de Reumatólogos de Cruces, 2; P. Richette, Menarini, 5,Grünenthal, 5; A. Stack, Health Research Board, 2,Midwest Research and Education Foundation, 2,Menarini International Operation Luxemburg, 2, 5,Grünenthal, 5,Astellas, 5; R. Karra Gurunath, Grünenthal, 3; M. J. GARCIA DE YEBENES Y PROUS, None; L. Carmona, None.

To cite this abstract in AMA style:

Perez-Ruiz F, Richette P, Stack A, Karra Gurunath R, GARCIA DE YEBENES Y PROUS MJ, Carmona L. Failure to Reach Serum Urate Target Is Associated with Elevated Mortality in Gout [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/failure-to-reach-serum-urate-target-is-associated-with-elevated-mortality-in-gout/. Accessed .
  • Tweet
  • Click to email a link to a friend (Opens in new window) Email
  • Click to print (Opens in new window) Print

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/failure-to-reach-serum-urate-target-is-associated-with-elevated-mortality-in-gout/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

All abstracts accepted to ACR Convergence are under media embargo once the ACR has notified presenters of their abstract’s acceptance. They may be presented at other meetings or published as manuscripts after this time but should not be discussed in non-scholarly venues or outlets. The following embargo policies are strictly enforced by the ACR.

Accepted abstracts are made available to the public online in advance of the meeting and are published in a special online supplement of our scientific journal, Arthritis & Rheumatology. Information contained in those abstracts may not be released until the abstracts appear online. In an exception to the media embargo, academic institutions, private organizations, and companies with products whose value may be influenced by information contained in an abstract may issue a press release to coincide with the availability of an ACR abstract on the ACR website. However, the ACR continues to require that information that goes beyond that contained in the abstract (e.g., discussion of the abstract done as part of editorial news coverage) is under media embargo until 10:00 AM ET on November 14, 2024. Journalists with access to embargoed information cannot release articles or editorial news coverage before this time. Editorial news coverage is considered original articles/videos developed by employed journalists to report facts, commentary, and subject matter expert quotes in a narrative form using a variety of sources (e.g., research, announcements, press releases, events, etc.).

Violation of this policy may result in the abstract being withdrawn from the meeting and other measures deemed appropriate. Authors are responsible for notifying colleagues, institutions, communications firms, and all other stakeholders related to the development or promotion of the abstract about this policy. If you have questions about the ACR abstract embargo policy, please contact ACR abstracts staff at [email protected].

Wiley

  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences

© Copyright 2025 American College of Rheumatology