Treat-to-target urate-lowering therapy and hospitalizations for gout: results from a nationwide cohort study in England

Abstract Objective To investigate associations between treat-to-target urate-lowering therapy (ULT) and hospitalizations for gout. Methods Using linked Clinical Practice Research Datalink and NHS Digital Hospital Episode Statistics data, we described the incidence and timing of hospitalizations for...

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Bibliographic Details
Published in:Rheumatology (Oxford, England) England), 2023-07, Vol.62 (7), p.2426-2434
Main Authors: Russell, Mark D, Roddy, Edward, Rutherford, Andrew I, Ellis, Benjamin, Norton, Sam, Douiri, Abdel, Gulliford, Martin C, Cope, Andrew P, Galloway, James B
Format: Article
Language:English
Subjects:
Clinical Science
Cohort Studies
Colchicine
Colchicine - therapeutic use
Disease prevention
England - epidemiology
Gout
Gout - complications
Gout - drug therapy
Gout - epidemiology
Gout Suppressants - therapeutic use
Hospitalization
Humans
Prophylaxis
Uric Acid
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Summary:Abstract Objective To investigate associations between treat-to-target urate-lowering therapy (ULT) and hospitalizations for gout. Methods Using linked Clinical Practice Research Datalink and NHS Digital Hospital Episode Statistics data, we described the incidence and timing of hospitalizations for flares in people with index gout diagnoses in England from 2004–2020. Using Cox proportional hazards and propensity models, we investigated associations between ULT initiation, serum urate target attainment, colchicine prophylaxis, and the risk of hospitalizations for gout. Results Of 292 270 people with incident gout, 7719 (2.64%) had one or more hospitalizations for gout, with an incidence rate of 4.64 hospitalizations per 1000 person-years (95% CI 4.54, 4.73). There was an associated increased risk of hospitalizations within the first 6 months after ULT initiation, when compared with people who did not initiate ULT [adjusted Hazard Ratio (aHR) 4.54; 95% CI 3.70, 5.58; P 
ISSN:1462-0324
1462-0332
DOI:10.1093/rheumatology/keac638