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.
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.”
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