Alcohol Consumption as a Trigger of Recurrent Gout Attacks

Zhang, Yuqing; Woods, Ryan; Chaisson, Christine E.; Neogi, Tuhina; Niu, Jingbo; McAlindon, Timothy E.; Hunter, David J.

doi:10.1016/j.amjmed.2006.01.020

Cited by 91 publications

(58 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As in prior Internet-based studies [25][26][27][28], we found a high degree of reliability in participants' responses. Indeed, the concordance of self-reported with recorded weight among individuals with high BMI exceeded that documented in more traditional approaches [29,30]-perhaps reflecting the sense of anonymity afforded by the Internet [31][32][33].…”

Section: Discussionsupporting

confidence: 54%

“…We obtained reliable information from participants, and were able demonstrate convergent construct validity by confirming associations with a panel of disease epiphenomena. Although certain aspects would benefit from further development, especially the approach to recruitment of samples for which the source population has measurable characteristics, the approach holds promise as a way to perform epidemiologic research into rare disorders, and adds to the portfolio of study designs that have been deployed over the Internet [25][26][27][28].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Feasibility and validity were demonstrated of an online case–control study using the prototype of recent-onset systemic lupus erythematosus

McAlindon

Wang

Formica

et al. 2008

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

Objective-To test the feasibility and validity of the online case-control study design through the empirical deployment of a prototype study of recent-onset systemic lupus erythematosus (SLE).Study Design and Setting-We conducted an Internet-based case-control study of SLE during [2003][2004][2005]. The source population comprised Google users searching on medical key terms, solicited using sponsored links. Cases fulfilled a self-administered algorithm for SLE diagnosed within 5 years. A subset underwent confirmation by medical record review. Controls were matched to cases using a propensity score.Results-Four hundred and two cases and 693 control applicants finished the questionnaires, yielding 389 matched case-control pairs. Eighty-two percentage of the records documented a clinical diagnosis of SLE, and 61% documented ≥4 American College of Rheumatology criteria for SLE. Control applicants resembled Internet users, with the exceptions of comprising more women (86% vs. 52%) and fewer minority individuals (e.g., 5% vs. 9% for African-Americans). There was a broad representation of clinical manifestations. SLE was associated with miscarriage (odds ratio [OR] = 3.0, 95% confidence interval [CI] = 2.0-4.7), allergy to sulfonamides (OR = 2.2, CI = 1.5-3.2), hives (OR = 1.9, CI = 1.4-2.5), and shingles (OR = 2.3, CI = 1.4-3.7).Conclusion-It is possible to perform case-control studies over the Internet using an internally valid design, obtain reliable information from participants, and confirm established associations.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

Feasibility and validity were demonstrated of an online case–control study using the prototype of recent-onset systemic lupus erythematosus

McAlindon

Wang

Formica

et al. 2008

Journal of Clinical Epidemiology

View full text Add to dashboard Cite

show abstract

“…In this context, internet-based case-crossover methodology has been useful for analysis of exposures to well-defined and scientifically rational hazards for gout patients (alcohol, purine-rich, foods and diuretics) that would not be ethically appropriate for randomised clinical trials. In such studies, acute purine intake of animal origin increased OR for recurrent gout attacks by nearly fivefold,3 and OR for recurrent gout attacks were 2.0–2.5 for 5–7 or more drinks of any form of alcohol consumed over a 2-day period 4. Such studies, and a larger body of epidemiological evidence, reinforce the portion of ACR 2012 gout management guidelines5 6 related to dietary recommendations.…”

Section: Commentarymentioning

confidence: 67%

Are cherries now ripe for use as a complementary therapeutic in gout? Appraisal of the state of evidence

Terkeltaub¹

2013

Evid Based Med

View full text Add to dashboard Cite

Commentary on: Zhang Y, Neogi T, Chen C, et al. Cherry consumption and decreased risk of recurrent gout attacks. Arthritis Rheum 2012;64:4004-11. ContextThe prevalence of gout has risen in the USA and many other countries, owing to a 'perfect storm' of factors, including increased prevalence of comorbid conditions, and diet and alcohol consumption megatrends. Resultant increase in clinical complexity of gouty arthritis and hyperuricaemia management is compounded by relatively poor patient adherence compared to many other medical conditions. This is partly because of gaps in patient and physician education. Notwithstanding, there is substantial interest by patients and clinicians in inexpensive and health-promoting non-pharmacological modalities to potentially improve gout management. Cherries and cherry products, buttressed by an initial uncontrolled study, 1 are a popular folk remedy for gout, as evidenced by more than 1 600 000 'hits' (as of January 2013) in an internet search for the topic 'cherry and gout'. Burgeoning commercial aspects of this phenomenon were linked to US Food and Drug Administration (FDA) warnings to cherry product manufacturers about therapeutic claims in advertisements and websites. There is at least some science on cherries pertinent to gout, which includes evidence for antiinflammatory properties of cherry anthocyanins, and moderate serum urate lowering 2 possibly related to xanthine oxidase inhibition, and to ascorbate uricosuric effects. The work reviewed here is the largest clinical study of cherry consumption to combat gout, to date. MethodsThe internet-based case-crossover study by Zhang and colleagues examined associations of putative risk factors with recurrent attacks of acute gout. Gout patients (n=633) were prospectively recruited and then monitored online for 12 months. To do so, the authors designed a website, and recruited individuals from most states of the USA. Gout diagnosis met preliminary American College of Rheumatology (ACR) criteria in 87.5% of individuals, as confirmed by their physicians. Participants recorded multiple details about their acute gout attacks, including medications and exposure to potential hazards or protective factors during the 2-day period prior to the gout attack, or over four prespecified 2-day control periods; patients served as their own controls. One serving of cherries was defined as half a cup (∼10-12 cherries). Risk of recurrent gout flare was estimated via conditional logistic regression, with multivariate analysis. FindingsMultiple findings suggested cherry intake to be associated with decreased risk of gout attacks. Risk reduction was greater in those who consumed two servings/day of cherry fruit compared to those who consumed one serving, with risk found to be further reduced in those consuming three servings/day ((OR) 0.39, 95% CI 0.20 to 0.77). This trend did not continue to be the same for those consuming four or more cherry servings. Cherry extract intake showed an inverse association with gout flare, similar to that with cherry ...

show abstract

“…Dietary factors have been implicated in the pathogenesis of gout in two ways; firstly, as a risk factor for hyperuricaemia as investigated in this study, and secondly, as a trigger for flares of acute gout 56. Whether and which dietary factors trigger acute flares is not the subject of this study, but is often of considerable interest to people with gout 7…”

mentioning

confidence: 97%