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Abstract Number: 145

Prevalence of Non-Gout Arthritis in Patients with Gout: Not As Sparing As Previously Thought

Fernando Perez-Ruiz1 and Ana M. Herrero-Beites2, 1Servicio de Reumatologia, Hospital Universitario Cruces, Baracaldo, Spain, 2Physical Medicine Division, Hospital de Gorliz, Gorliz, Spain

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: gout

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Session Information

Session Title: Metabolic and Crystal Arthropathies

Session Type: Abstract Submissions (ACR)

Background/Purpose: the presence of other chronic inflammatory disease has been historically and academically thought to be “protective” conditions for the development of gout.

Objective: to evaluate the presence of concomitant chronic arthritis in patients with gout.

Methods: analysis of a dataset from a 20-year cohort of patients with gout prospectively included for follow-up. Diagnosis of associated rheumatic diseases at baseline or during follow-up were included if present. Classification criteria for such concomitant diseases varied depending on the classification criteria at the moment diagnosis was made.

Results: from 904 patients with 3,315 patient-year observation. Diagnosis of gout was based on crystal observation in 731 (80.8%). The number of patients and cumulated prevalence (n/%) of pyrophosphate arthritis (PPA), rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthritis (SpA) were 46/5.09, 5/0.55, 4/0.44, 3/0.33 respectively, very close to that expected in the general population. All patients with a diagnosis of both disease had crystal-proven gout (MSU crystals) or crystal (CPP)+X-ray proven PPA. Previous PPA was present in 3/46 patients, and both CPP and MSU crystals were observed in the same synovial fluid sample in 13/46, in the 23 left PPA appearing after properly controlled gout, no MSU crystals being observed in synovial fluid. Previous RA was present in 4/5 patients, previous PsA in 3/3, and previous SpA in 3/3. Only a patient developed RA 2-year after being satisfactorily treated for crystal proven gout, and showing high titers of RF and anti-CCP antibodies.Patients with PPA and RA showed higher age and more frequent chronic kidney disease than patients with PsA or SpA. Diuretic use, a risk factor for gout, was frequent in all groups (Table 1).

 

Age

Serum urate (mg/dl)

CKD

(% 3-5)

BMI

(kg/sqm)

DIURETICS

(%)

PPA

73±10

8.75±1.31

52

27.8±4.1

48

RA

67±11

9.06±1.17

40

27.9±2.9

20

PsA

56±9

9.80±2.04

0

29.2±4.5

25

SpA

58±6

8.73±1.72

33

27.7±0.1

33

Conclusion:   the cumulated prevalence of other arthritis is as much in patients with gout as expected in the general population. Systematic analysis of synovial fluid samples, despite a previous and well established previous diagnosis allows to identify MSU and CPP crystals in patients suffering from other joint diseases but also to identify CPP crystals in patients with 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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