Patients With Early-Onset Gout Develop Earlier Metabolic Comorbidities, Severe Joint Involvement

gout and RA
gout and RA
Patients with early-onset gout experience more severe acute joint involvement and earlier metabolic comorbidities than those with common gout.

Patients with early-onset gout experience more frequent polyarticular flares, more severe acute joint involvement, and earlier metabolic comorbidities than those with common gout, according to a study recently published in Arthritis Care & Research. 

This study included 120 participants with early-onset gout, aged 49 ± 11.9 years and 865 participants with common gout who were aged 64.4 ± 10.1 years. Those with early-onset gout showed a history of more frequent polyarticular flares than those with common gout (P <.01), but the 2 groups experienced similar incidences of gout arthropathy (P =.79), flares (P =.16), and tophi (P =.53). The items composing metabolic syndrome showed similar prevalence among both groups. In individuals with early-onset gout, all cardiovascular comorbidities were identified after disease onset. Multivariate analysis revealed an association with increased age, high alcohol intake, and low HDL among those with common gout; among those with early-onset gout, researchers found longer urate-lowering treatment, family history of gout, metabolic syndrome, and higher levels of serum urate.

Participants in the early-onset group, who experienced their first gout flare before age 40, were recruited from the cross-sectional French national cohort GOSPEL. This group was compared with a group of participants with common gout, who experienced their first flare after age 40. Clinical characteristics, history of gout, comorbidities, and prescribed treatments were recorded and analyzed.

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The study researchers concluded that patients with early-onset gout ” presented with fewer renal and physician-identified cardiovascular comorbidities than the common profile of gouty patients followed in clinical practice. Yet, notwithstanding their younger age, patients with [early-onset gout] presented with joint involvement as severe as patients 15 years older with the so-called classical profile.”

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Pascart T, Norberciak L, Ea HK, Pascal G, Lioté F. GOSPEL 4 – Patients with early onset gout develop earlier severe joint involvement and metabolic comorbid conditions [published online July 19, 2018]. Arthritis Care Res. doi: 10.1002/acr.23706