Prevalence of comorbidities and management of gout in a tropical city in Australia

Jeyaruban, Andrew; Soden, Muriel; Larkins, Sarah

doi:10.1007/s00296-016-3580-6

Cited by 6 publications

(13 citation statements)

References 15 publications

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“…There is well-recognized evidence of a high prevalence of comorbidities in the gout population [ 20 ]. After adjustment for sociodemographic variables, we observed an association between gout and concomitant medication use for hypertension and hypercholesterolemia, which are the most common comorbidities observed in patients with prevalent gout in most international studies [ 5 , 14 , 20 , 45 ]. Other relevant comorbidities, such as cardiovascular disease and diabetes mellitus, although more frequent in respondents with gout, were not independently associated with gout after adjustment for sociodemographic variables.…”

Section: Discussionmentioning

confidence: 90%

Gout prevalence and predictors of urate-lowering therapy use: results from a population-based study

et al. 2018

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BackgroundGout has an increasing global prevalence. Underutilization of urate-lowering therapy (ULT) is thought to be common, via both suboptimal dosing and poor medication adherence. The aims of this study were to determine the prevalence of self-reported gout and the key predictors of ULT use in those with gout in a representative population survey in South Australia.MethodsData were obtained from the Spring 2015 South Australian Health Omnibus Survey, a multilevel, systematic, survey in a representative population sample involving face-to-face interviews (n = 3005). This study analyzed responses from respondents aged ≥ 25 years (n = 2531) about self-reported gout, ULT use, sociodemographic factors, lifestyle factors, and comorbidities, using survey weighting. Univariate and subsequent adjusted logistic regression analyses on self-reported gout were performed. ULT use was divided into three categories (never use, prior use, and current use) and these data were analyzed using a multinomial logistic regression model.ResultsSelf-reported gout prevalence was 6.8% (95% CI 5.8, 7.9). The mean age of respondents with gout was 64 years (standard deviation 16) and 82% were male. As expected, older age, male gender, lower socioeconomic status (SES), and higher body mass index (BMI) were associated with gout, as were high alcohol consumption, current smoking, other forms of arthritis, and hypertension or hypercholesterolemia medication, after adjustment for sociodemographic variables. Two thirds of respondents with gout reported ULT use (36% current; 29% previous) with only 55% continuing treatment. Predictors of ULT use included male gender, low SES, and concomitant cholesterol-lowering therapy. Respondents with gout with a higher BMI were more likely to remain on ULT.ConclusionsDespite gout being a common, potentially disabling joint disease, only 55% of respondents with gout in this study adhered to ULT. Identification of key predictors of ULT use will provide guidance on prescribing strategy in clinical practice and on the quality of gout care in the community.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1633-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 90%

Gout prevalence and predictors of urate-lowering therapy use: results from a population-based study

et al. 2018

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“…Notably, some individuals carrying a rare variant in IL37 exhibited a strikingly severe clinical phenotype or multiple inflammatory comorbidities. Their clinical phenotype was remarkably severe, even considering the already high incidence of cardiovascular, metabolic and renal comorbidities in gout patients 47–49. However, due to the limited number of individuals carrying rare variants, larger follow-up studies are needed for statistical confirmation.…”

Section: Discussionmentioning

confidence: 99%

Rare genetic variants in interleukin-37 link this anti-inflammatory cytokine to the pathogenesis and treatment of gout

Klück

Deuren

Cavalli³

et al. 2020

Ann Rheum Dis

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ObjectiveGout is characterised by severe interleukin (IL)-1-mediated joint inflammation induced by monosodium urate crystals. Since IL-37 is a pivotal anti-inflammatory cytokine suppressing the activity of IL-1, we conducted genetic and functional studies aimed at elucidating the role of IL-37 in the pathogenesis and treatment of gout.MethodsVariant identification was performed by DNA sequencing of all coding bases of IL37 using molecular inversion probe-based resequencing (discovery cohort: gout n=675, controls n=520) and TaqMan genotyping (validation cohort: gout n=2202, controls n=2295). Predictive modelling of the effects of rare variants on protein structure was followed by in vitro experiments evaluating the impact on protein function. Treatment with recombinant IL-37 was evaluated in vitro and in vivo in a mouse model of gout.ResultsWe identified four rare variants in IL37 in six of the discovery gout patients; p.(A144P), p.(G174Dfs*16), p.(C181*) and p.(N182S), whereas none emerged in healthy controls (Fisher’s exact p-value=0.043). All variants clustered in the functional domain of IL-37 in exon 5 (p-value=5.71×10−5). Predictive modelling and functional studies confirmed loss of anti-inflammatory functions and we substantiated the therapeutic potential of recombinant IL-37 in the treatment of gouty inflammation. Furthermore, the carrier status of p.(N182S)(rs752113534) was associated with increased risk (OR=1.81, p-value=0.031) of developing gout in hyperuricaemic individuals of Polynesian ancestry.ConclusionHere, we provide genetic as well as mechanistic evidence for the role of IL-37 in the pathogenesis of gout, and highlight the therapeutic potential of recombinant IL-37 for the treatment of gouty arthritis.

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“…The incidence and prevalence of gout are rapidly rising [3,4]. Gout may shortly exceed 3% of the adult population [1].…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Hypertension in Sudanese Patients With Gouty Arthritis

Khaild¹,

Fagir²,

Taha³

et al. 2022

Cureus

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BackgroundIn this study, we aimed to study the frequency of hypertension in Sudanese patients with gouty arthritis attending the largest three tertiary hospitals in Khartoum and correlate it with serum uric acid levels. MethodologyAn observational, descriptive, cross-sectional, hospital-based study was conducted in rheumatology clinics in Khartoum state, Sudan, from August 2020 to January 2021 involving 100 participants. Data were collected, prepared, and analyzed using SPSS version 25.0 (IBM Corp., Armonk, NY, USA). ResultsIn this study, 100 participants were enrolled. The majority were males (79%), with 45% of the participants in the age group of 61-75 years. Overall, 89% of participants had symptoms of gouty arthritis, with the knee being the most common joint affected in 27% of participants. Most participants had a uric acid level above the target (6 mg/dL). The most frequently used uric acid lowering agent was found to be allopurinol in 85% of the patients. Furthermore, among those with gouty arthritis, 51% had hypertension with nearly half being insufficiently controlled. The frequency of undiagnosed hypertension among the participants was found to be 19%, which was statistically significant among gouty arthritis patients (p-value < 0.0001). Upon further analysis of our hypertensive participants, 79.5% of males (n = 35) had high blood pressure levels, which was statistically significant as well (p-value = 0.005), with the highest prevalence being among the age group of 61-75 years. Of those who were hypertensive, 51% had a history of concomitant comorbidity. Overall, 90% of the hypertensive participants (n = 40) had joint symptoms. Moreover, serum uric acid level was above the target in 93% of the participants. ConclusionsHypertension was found to be the most frequently recognized comorbidity in gouty arthritic patients, with more than a third remaining undiagnosed. Moreover, the male gender was a significant risk factor for hypertension among the gouty arthritis participants. Nevertheless, most patients with high blood pressure levels had concurrent elevated uric acid levels.

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Prevalence of comorbidities and management of gout in a tropical city in Australia

Cited by 6 publications

References 15 publications

Gout prevalence and predictors of urate-lowering therapy use: results from a population-based study

Gout prevalence and predictors of urate-lowering therapy use: results from a population-based study

Rare genetic variants in interleukin-37 link this anti-inflammatory cytokine to the pathogenesis and treatment of gout

Prevalence of Hypertension in Sudanese Patients With Gouty Arthritis

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