Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Little is known regarding the evaluation, characteristics and management of women with gout. To characterize potential gender differences, we therefore compared clinical manifestations and treatment of women versus men in a nationwide sample of men and women with gout cared for by rheumatologists.
Methods:
Rheumatologists participating in the Consortium of Rheumatology Researchers of North America (CORRONA) registry agreed to enroll their gout patients regardless of gender, disease severity, disease activity or medication use. All patients enrolled between 11/1/12 and 5/1/13 were included in the current study. Data was gathered at the time of enrollment from patients and their rheumatologists including demographics, gout evaluation, clinical characteristics, comorbid conditions, current treatments, and physical exam findings. Logistic regression models were created to examine the influence of sex on use of a urate-lowering drug (ULD) adjusting for patient age and duration of gout and accounting for clustering by practice site.
Results:
Fifty-four rheumatologists enrolled 109 women and 414 men with gout. Women were older (71 vs. 62 years, p<0.001) and more commonly had a comorbid illness including hypertension (76% vs. 59%, p=0.001), diabetes (32% vs. 17%, p=0.001) and renal disease (29% vs. 14%, p<0.001). Women had a shorter duration of gout (6 vs. 11 years, p<0.001) and were less likely to have a crystal proven diagnosis (19% vs. 34%, p=0.003). While women had similar clinical features in terms of acute gout presentation (e.g., podagra, oligoarthritis, etc), and gouty arthritis (tophi, joint deformity), they were more likely to have contraindications to treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) (32% vs. 21%, p=0.02) or colchicine (14% vs. 6%, p=0.01). Among those patients with 2 or more attacks per year or those with tophi, women (n=63) were less likely to be on a urate-lowering drug (ULD) as compared to men (n=233) (78% vs. 89%, p=0.02) in both unadjusted and adjusted (OR 0.42, 95% CI 0.19-0.92) analyses.
Conclusion:
Compared to men, women with gout were older and less likely to have received a definitive diagnosis of gout by crystal identification. Women were more likely to have contraindications to NSAIDs and colchicine, and less likely to be receiving ULDs. Our data suggest the presence of health care disparities between women and men with gout, and that gout in women may have unique features and challenges. Further investigation is needed to ensure optimal care in women with gout.
Disclosure:
L. R. Harrold,
CORRONA, Inc.,
5;
C. Etzel,
CORRONA, Inc.,
3;
A. Gibofsky,
Abbvie, Amgen, BMS, GlaxoSmithKline, Johnson and Johnson, Pfizer Inc, Genentech,
1,
Abbvie, Amgen, AstraZeneca, Celgene, Horizon, Iroko, Pfizer Inc, Genentech,
5,
Abbvie, Amgen, Pfizer Inc, Genentech,
8;
J. M. Kremer,
CORRONA, Inc.,
1,
CORRONA, Inc.,
3;
M. H. Pillinger,
Takeda Pharmaceuticals,
2,
Savient Pharmaceuticals,
2;
K. G. Saag,
Takeda Pharmaceuticals,
2,
Ardea ,
2,
Regeneron,
2,
Savient Pharmaceuticals,
2,
Takeda Pharmaceuticals,
5,
Ardea,
5,
Regeneron,
5,
Savient Pharmaceuticals,
5;
N. Schlesinger,
Novartis Pharmaceutical Corporation,
2,
Novartis Pharmaceutical Corporation, Sobi,
5,
Novartis Pharmaceutical Corporation; Takeda Pharmaceuticals, Savient Pharmaceuticals,
8,
Novartis Pharmaceutical Corporation, Takeda Pharmaceuticals, Savient Pharmaceuticals, Sobi,
9;
R. Terkeltaub,
VA Research Service,
2,
Takeda Pharmaceuticals,
5,
Savient Pharmaceuticals,
5,
Ardea,
5,
BioCryst,
5,
Novartis Pharmaceutical Corporation,
5,
Regeneron,
5,
Sobi,
5,
Pfizer Inc,
5,
Abbvie,
5;
V. Cox,
CORRONA, Inc.,
3;
J. D. Greenberg,
CORRONA, Inc.,
1,
AstraZeneca, CORRONA, Inc., Novartis, Pfizer Inc,
5.
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