Impact of Bariatric Surgery on Gout Medication: a Nationwide Cohort Study

While bariatric surgery (BS) is an effective treatment for gout in patients with morbid obesity, little is known about how BS influences subsequent use of gout medications. We investigated the impact of BS on gout medication use.

This retrospective nationwide cohort study used data from South Korea, including all patients who underwent BS in 2019-2020. A control group was created using propensity score matching. The primary outcome was the change in the proportion of patients using gout medications, categorized as urate-lowering therapy (ULT) or acute medications. We assessed hazard ratios for discontinuation and reinitiation of medications after BS using Cox regression.

The study included 3804 participants in the BS group and 15,240 propensity score-matched controls. Over the 3 years after surgery, ULT use in the BS group declined to rates comparable to those in controls from month 13 onward, and discontinuation was more likely in the BS cohort (adjusted hazard ratio, 1.80; 95% confidence interval, 1.37-2.37). In contrast, although acute medication use also decreased after BS, its rate remained higher than in controls, and discontinuation did not differ significantly. Similarly, the 3-year rate of gout medication reinitiation did not differ significantly between groups.

Over 3 years after BS, overall gout medication use in the BS group declined to a level comparable to that in controls, with a significantly higher ULT discontinuation rate. Discontinuation of acute gout medications did not differ significantly.