Gout Associated With Elevated Venous Thromboembolism Risk

Gout was found to be associated with increased venous thromboembolism (VTE) risk, according to findings of a systematic review and meta-analysis published in International Journal of Rheumatic Diseases.

Evidence suggests that VTE risk is increased among patients with inflammatory rheumatic diseases. However, little is known about the exact relationship between VTE and gout.

Therefore, to evaluate VTE risk in gout, researchers from Central South University in China searched publication databases through June 2021 for relevant studies.

A total of 5 articles including 287,529 patients with gout and 355,103 control participants without gout were included in the analysis. The studies were published between 2015 and 2020, were of retrospective (n=4) or prospective (n=1) cohort designs, and were conducted in the US, Canada, UK, and Taiwan.

Four studies found that gout was associated with higher risk for VTE, with a pooled hazard ratio (HR) of 1.33 (95% CI, 1.21-1.46; I²=62.2%; P <.001).

Stratified by VTE subtype, 3 studies showed that gout was associated with increased risk for deep vein thrombosis (DVT; HR, 1.40; 95% CI, 1.22-1.62; I²=65.5%; P <.001) and 2 studies showed an increased risk for pulmonary embolism (PE; HR, 1.18; 95% CI, 1.07-1.30; I²=39.5%; P =.001).

In subgroup analyses, trends were similar when stratifying by sample size (P =.865), duration of follow-up (P =.670), definition of gout (P =.503), and sex (P =.812). However, the relationship between gout and VTE was significantly stronger in studies published prior to vs after 2016 (HR, 1.47 vs 1.23; P <.001) and in studies with a quality score lower than 8 vs 8 and greater (HR, 1.55 vs 1.25; P <.001).

In a sensitivity analysis, the association between gout and VTE ranged from HRs of 1.25 to 1.38; no statistically significant publication bias was indicated.

The limitations of the analysis included the number of relevant studies available and the inability to stratify by ethnicity due to lack of data.

The study authors concluded, “Our study provided evidence that gout was associated with the risk of VTE and its subtypes DVT and PE. However, more prospective and high-quality clinical evidence is required to confirm our findings.”