The unclosing premature mortality gap in gout: a general population-based study

Area of Science:

• Rheumatology
• Epidemiology
• Public Health

Background:

• Gout is the most prevalent inflammatory arthritis.
• Gout is linked to increased premature mortality.
• The trend of this mortality gap over time is not well-established.

Purpose of the Study:

• To investigate if the mortality gap in gout patients has improved over time.
• To compare mortality trends in gout with those observed in rheumatoid arthritis (RA).

Main Methods:

• Utilized a UK electronic medical record database (1999-2014).
• Identified incident gout cases and controls, dividing gout patients into early (1999-2006) and late (2007-2014) diagnosis cohorts.
• Compared mortality rates and hazard ratios (HRs), adjusting for confounders; conducted sensitivity analyses for urate-lowering therapy.

Main Results:

• Both early and late gout cohorts exhibited similar excess mortality compared to controls.
• Mortality hazard ratios remained consistent across cohorts (multivariable HRs: 1.10 and 1.09).
• Sensitivity analyses confirmed these findings, indicating no significant change in mortality risk over time.

Conclusions:

• The premature mortality gap in gout patients has remained unchanged over the past 16 years.
• This contrasts with improvements seen in rheumatoid arthritis mortality during the same period.
• Enhanced gout management and comorbidity treatment are crucial to address this persistent mortality gap.