Top

06-06-2017 | Gout | Article

Gout and subsequent erectile dysfunction: a population-based cohort study from England

Journal: Arthritis Research & Therapy

Authors: Alyshah Abdul Sultan, Christian Mallen, Richard Hayward, Sara Muller, Rebecca Whittle, Matthew Hotston, Edward Roddy

Publisher: BioMed Central

Abstract

Background

An association has been suggested between gout and erectile dysfunction (ED), however studies quantifying the risk of ED amongst gout patients are lacking. We aimed to precisely determine the population-level absolute and relative rate of ED reporting among men with gout over a decade in England.

Methods

We utilised the UK-based Clinical Practice Research Datalink to identify 9653 men with incident gout age- and practice-matched to 38,218 controls. Absolute and relative rates of incident ED were calculated using Cox regression models. Absolute rates within specific time periods before and after gout diagnosis were compared to control using a Poisson regression model.

Results

Overall, the absolute rate of ED post-gout diagnosis was 193 (95% confidence interval (CI): 184–202) per 10,000 person-years. This corresponded to a 31% (hazard ratio (HR): 1.31 95%CI: 1.24–1.40) increased relative risk and 0.6% excess absolute risk compared to those without gout. We did not observe statistically significant differences in the risk of ED among those prescribed ULT within 1 and 3 years after gout diagnosis. Compared to those unexposed, the risk of ED was also high in the year before gout diagnosis (relative rate = 1.63 95%CI 1.27–2.08). Similar findings were also observed for severe ED warranting pharmacological intervention.

Conclusions

We have shown a statistically significant increased risk of ED among men with gout. Our findings will have important implications in planning a multidisciplinary approach to managing patients with gout.

Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Rising burden of gout in the UK but continuing suboptimal management: a nationwide population study. Ann Rheum Dis. 2015;74(4):661–7.CrossRefPubMed

Choi HK, Ford ES, Li C, Curhan G. Prevalence of the metabolic syndrome in patients with gout: the Third National Health and Nutrition Examination Survey. Arthritis Rheum. 2007;57(1):109–15.CrossRefPubMed

Clarson LE, Chandratre P, Hider SL, Belcher J, Heneghan C, Roddy E, Mallen CD. Increased cardiovascular mortality associated with gout: a systematic review and meta-analysis. Eur J Prev Cardiol. 2015;22(3):335–43.CrossRefPubMedPubMedCentral

Prins J, Blanker MH, Bohnen AM, Thomas S, Bosch JL. Prevalence of erectile dysfunction: a systematic review of population-based studies. Int J Impot Res. 2002;14(6):422–32.CrossRefPubMed

Schlesinger N, Radvanski DC, Cheng JQ, Kostis JB. Erectile dysfunction is common among patients with gout. J Rheumatol. 2015;42(10):1893–7.CrossRefPubMed

Chen YF, Lin HH, Lu CC, Hung CT, Lee MH, Hsu CY, Chung WS. Gout and a subsequent increased risk of erectile dysfunction in men aged 64 and under: a nationwide cohort study in Taiwan. J Rheumatol. 2015;42(10):1898–905.CrossRefPubMed

Hsu CY, Lin CL, Kao CH. Gout is associated with organic and psychogenic erectile dysfunction. Eur J Intern Med. 2015;26(9):691–5.CrossRefPubMed

Clinical Practice Research Database. http://www.cprd.com/intro.asp. Accessed 2 Jan 2017.

Crooks C. Epidemiology of upper gastrointestinal bleeding studying its causes and outcomes using case control studies and surivival analyses. Ph.D. Thesis. University of Nottingham; 2013.

10.

Meier CR, Jick H. Omeprazole, other antiulcer drugs and newly diagnosed gout. Br J Clin Pharmacol. 1997;44(2):175–8.CrossRefPubMedPubMedCentral

11.

Dafni U. Landmark analysis at the 25-year landmark point. Circ Cardiovasc Qual Outcome. 2011;4(3):363–71.CrossRef

12.

Giobbie-Hurder A, Gelber RD, Regan MM. Challenges of guarantee-time bias. J Clin Oncol. 2013;31(23):2963–9.CrossRefPubMedPubMedCentral

13.

Kuo CF, Grainge MJ, Mallen C, Zhang W, Doherty M. Effect of allopurinol on all-cause mortality in adults with incident gout: propensity score-matched landmark analysis. Rheumatology (Oxford). 2015;54(12):2145–50.

14.

Gelber AC. Gout and association with erectile dysfunction. J Rheumatol. 2015;42(10):1731–3.CrossRefPubMed