Session Information
Date: Monday, October 22, 2018
Title: Metabolic and Crystal Arthropathies – Basic and Clinical Science Poster I
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: In the presence of limited available data, our objective was to assess the association of gout with the risk of incident Parkinson’s disease (PD) in older adults ³65 years.
Methods: We used the 5% Medicare claims data from 2006-2012 for this cohort study. Gout was identified by the presence of two claims for gout at least 4 weeks apart, with International Classification of Diseases, ninth revision, common modification (ICD-9-CM) code of 274.xx. Study outcome was incident GCA, identified by two claims for PD with an ICD-9-CM code of 446.5, at least 4 weeks apart and an absence of PD claims in the baseline 365-day period, a valid approach. We used multivariable-adjusted Cox proportional hazard models to assess the association of gout with incident GCA, adjusting for potential confounders/covariates including demographics (age, race, gender), comorbidities (Charlson-Romano comorbidity index), and medications commonly used for cardiac diseases (statins, beta-blockers, diuretics, and angiotensin converting enzyme (ACE)-inhibitors) and gout (allopurinol and febuxostat; Model 1).
Results: In a cohort of 1.72 million people, the mean age was 75 years (standard deviation [SD], 7.6), mean Charlson-Romano comorbidity index score was 1.60 (SD, 2.39), 58% were female, 86% were White and 37% had Charlson-Romano comorbidity index score of ≥2. Of these, 22,636 people developed incident PD during the study follow-up, 1,129 with gout and 21,507 without gout, with respective crude incidence rates of incident PD of 3.7 vs. 2.2 per 1,000 person-years, respectively. Gout was associated with a higher risk of PD in the main analysis, 1.14 (95% CI, 1.07, 1.21). Sensitivity analyses confirmed main findings. No gender or race differences were noted, but the risk differed slightly by age; ages 65-75, 75-85 and >85 had hazard ratios of incident PD with gout of 1.27 (95% CI, 1.16, 1.39), 1.07 (95% CI, 0.97, 1.16) and 0.97 (95% CI, 0.79, 1.20), respectively (Table 1).
Conclusion: Gout was associated with a higher risk of incident PD in older adults. The risk of PD with gout was highest in the age group 65-75 years. Mechanisms of this increased risk need to be evaluated in future studies.
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Table 1. Association of gout with Parkinson’s Disease, in pre-defined subgroup analyses, varying by age, gender and race |
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Multivariable-adjusted (Model 1) |
Multivariable-adjusted (Model 1) |
Multivariable-adjusted (Model 1) |
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HR (95% CI) |
P-value |
HR (95% CI) |
P-value |
HR (95% CI) |
P-value |
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65-<75 years |
75- <85 years |
≥85 years |
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Gout |
1.27 (1.16, 1.39) |
<0.0001 |
1.07 (0.97, 1.16) |
0.17 |
0.97 (0.79, 1.20) |
0.77 |
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Female |
Male |
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Gout |
1.17 (1.06, 1.30) |
0.003 |
1.11 (1.03, 1.20) |
0.006 |
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Black |
White |
Other race |
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Gout |
1.09 (0.87, 1.36) |
0.46 |
1.13 (1.06, 1.21) |
0.0003 |
1.36 (1.05, 1.77) |
0.02 |
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Interaction terms: Gout*age p-value <0.0001; Gout*gender p-value = 0.52; Gout*race p-value = 0.65 HR, Hazard ratio; CI, confidence interval; Bold estimates represent those with statistical significance, i.e., p-value <0.05 |
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To cite this abstract in AMA style:
Singh JA, Cleveland J. Gout and the Risk of Parkinson’s Disease in Older Adults: A Study of U.S. Medicare Data [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 9). https://acrabstracts.org/abstract/gout-and-the-risk-of-parkinsons-disease-in-older-adults-a-study-of-u-s-medicare-data/. Accessed .« Back to 2018 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/gout-and-the-risk-of-parkinsons-disease-in-older-adults-a-study-of-u-s-medicare-data/