Omeprazole, other antiulcer drugs and newly diagnosed gout

Case-reports describing patients who developed a first episode of acute gout while being treated with the proton pump inhibitor omeprazole led us to compare incidence rates of newly diagnosed gout cases among omeprazole, ranitidine and cimetidine users.

We conducted a cohort study with a nested case-control analysis using the UK-based General Practitioner Research Database (GPRD). The study encompassed a cohort of more than 53,000 subjects who received some 185,000 prescriptions for the three study drugs.

Neither current omeprazole vs recent use (age- and sex-adjusted relative risk 1.1, 95% CI 0.5-2.1), nor current omeprazole use in comparison with current use of the two histamine H2-receptor blockers was associated with an increased risk of developing newly diagnosed gout. Higher age (RR 2.4, 95% CI 1.5-3.9), male gender (RR 5.4, 95% CI 2.8-10.3), high body mass index (OR 3.3, 95% CI 1.0-10.9) and hypertension (OR 4.5, 95% CI 1.6-12.9) were all important risk factors for gout.

While other known risk factors were significantly associated with gout, current omeprazole use was not materially associated with an increased gout incidence.