Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Urate-Lowering Therapy Use Among US Adults with Gout and the Relationship Between Gout Treatment Status and Associated Comorbidities

Version 1 : Received: 9 January 2023 / Approved: 11 January 2023 / Online: 11 January 2023 (10:37:41 CET)

A peer-reviewed article of this Preprint also exists.

Ortiz-Uriarte, M.; Betancourt-Gaztambide, J.; Perez, A.; Roman, Y.M. Urate-Lowering Therapy Use among US Adults with Gout and the Relationship between Patients’ Gout Treatment Status and Associated Comorbidities. Rheumato 2023, 3, 74-85. Ortiz-Uriarte, M.; Betancourt-Gaztambide, J.; Perez, A.; Roman, Y.M. Urate-Lowering Therapy Use among US Adults with Gout and the Relationship between Patients’ Gout Treatment Status and Associated Comorbidities. Rheumato 2023, 3, 74-85.

Abstract

Introduction: Individuals with gout are at higher risk of developing chronic conditions, such as diabetes, chronic kidney disease (CKD), and cardiovascular diseases. In this study, the association between urate-lowering therapy (ULT) use and the prevalence of these conditions was evaluated. Methods: This observational, cross-sectional pharmacoepidemiologic study used the 2013-2018 biannual cycles of the National Health and Nutrition Examination Survey. The inclusion criteria were adults 30 years of age and older with a diagnosis of gout. The association between ULT treatment status and dyslipidemia, coronary heart disease, heart failure, hypertension, and chronic kidney disease was evaluated, as well as associations with select clinical laboratory biomarkers. Results: Use of ULT was 28.9% (95%CI 24.3%-33.9%). There was no significant association between ULT use and the prevalence of heart failure, coronary heart disease, hypertension, or dyslipidemia (p>0.05). Those on ULT had a lower mean eGFR compared to those not on treatment (68.03 versus 74.74 mL/min/1.73m², p=0.014). LDL- and HDL- and total cholesterol were significantly lower among those receiving ULT treatment (p<0.05). Conclusion: ULT use continues to be low among those with gout. Those on ULT were more likely to be diagnosed with CKD, college graduates and above, older males, and obese. Clinical guidelines conditionally recommend ULTs in co-morbid kidney disease; while our results may reflect guidelines recommendation for ULT use in CKD patients, worsening kidney function while taking ULT is unlikely. Further research is necessary to determine the long-term impact of ULTs on kidney function and cardiovascular biomarkers.

Keywords

gout; urate-lowering therapy; serum uric acid; pharmacoepidemiologic study; comorbidities

Subject

Medicine and Pharmacology, Medicine and Pharmacology

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