‘Reassuring’ findings on fracture risk in patients with gout
medwireNews: Results of a large observational study suggest that patients with gout do not have an elevated risk for fragility fractures.
“These findings should be reassuring to patients, health care policymakers and clinicians,” say Zoe Paskins (Keele University, UK) and fellow researchers.
As reported in CMAJ, the team used records of primary care consultations in the UK to analyze data from 31,781 patients with gout and 122,961 controls without gout matched for age, sex, and healthcare center.
In all, 8934 participants experienced a first fragility fracture over a median follow-up of 10.8 years. The absolute rates of fracture were similar among the patients with and without gout, at 53 and 55 per 10,000 person–years, respectively, translating into a hazard ratio of 0.95 after adjustment for factors including age, smoking, comorbidities, and medication use.
These findings remained consistent when patients were separated into subgroups based on age and sex, say the researchers. They note that although women with gout had higher rates of fracture than men with gout (117.7 vs 31.5 per 10,000 person–years), their excess fracture risk relative to their matched controls was not statistically significant.
Paskins and colleagues also found no association between the use of urate-lowering therapy and fracture risk. Gout patients who received at least 6 months of urate-lowering therapy had comparable fracture rates to those who did not receive such treatment, with corresponding 1-year rates of 62.7 and 62.0 per 10,000 person–years, and 3-year rates of 65.2 and 65.3 per 10,000 person–years, respectively.
Therefore, “urate-lowering therapy had neither a beneficial nor adverse effect on the long-term risk of fragility fracture,” write the study authors.
And they conclude: “Our use of a nationally representative cohort should enable our study findings to be generalizable not only to the UK but also to other developed countries with similar health care systems.”
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