Top

Published in:

Open Access 01-12-2017 | Research article

Sex differences in gout characteristics: tailoring care for women and men

Authors: Leslie R. Harrold, Carol J. Etzel, Allan Gibofsky, Joel M. Kremer, Michael H. Pillinger, Kenneth G. Saag, Naomi Schlesinger, Robert Terkeltaub, Vanessa Cox, Jeffrey D. Greenberg

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

Abstract

Background

To characterize the differences between women and men with gout.

Methods

We analyzed a US national cohort of gout patients cared for by rheumatologists.

Results

Compared with the 1012 men with gout, women with gout (n = 262) were older (71 vs. 61 years, p < 0.001) and had a greater burden of comorbid conditions (p < 0.001 for hypertension, diabetes, renal disease and obesity). Risk factors for gout differed with women more often taking diuretics (p < 0.001), while men more frequently had dietary triggers (p < 0.05).

Conclusions

The profiles of women and men with gout are markedly different, suggesting a need to tailor treatment recommendations.

Available only for authorised users

Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007–2008. Arthritis Rheum. 2011;63:3136–41.CrossRefPubMed

Bieber JD, Terkeltaub RA. Gout: on the brink of novel therapeutic options for an ancient disease. Arthritis Rheum. 2004;50:2400–14.CrossRefPubMed

Singh JA, Strand V. Gout is associated with more comorbidities, poorer health-related quality of life and higher healthcare utilisation in US veterans. Ann Rheum Dis. 2008;67:1310–6.CrossRefPubMed

Edwards NL, Sundy JS, Forsythe A, Blume S, Pan F, Becker MA. Work productivity loss due to flares in patients with chronic gout refractory to conventional therapy. J Med Econ. 2011;14:10–5.CrossRefPubMed

Krishnan E, Baker JF, Furst DE, Schumacher HR. Gout and the risk of acute myocardial infarction. Arthritis Rheum. 2006;54:2688–96.CrossRefPubMed

Lally EV, Ho Jr G, Kaplan SR. The clinical spectrum of gouty arthritis in women. Arch Intern Med. 1986;146:2221–5.CrossRefPubMed

Puig JG, Michan AD, Jimenez ML, Perez de Ayala C, Mateos FA, Capitan CF, et al. Female gout. Clinical spectrum and uric acid metabolism. Arch Intern Med. 1991;151:726–32.CrossRefPubMed

Harrold LR, Yood RA, Mikuls TR, Andrade SE, Davis J, Fuller J, et al. Sex differences in gout epidemiology: evaluation and treatment. Ann Rheum Dis. 2006;65:1368–72.CrossRefPubMedPubMedCentral

Terkeltaub RA, Schumacher HR, Carter JD, Baraf HS, Evans RR, Wang J, et al. Rilonacept in the treatment of acute gouty arthritis: a randomized, controlled clinical trial using indomethacin as the active comparator. Arthritis Res Ther. 2013;15:R25.CrossRefPubMedPubMedCentral

10.

Sundy JS, Baraf HS, Yood RA, Edwards NL, Gutierrez-Urena SR, Treadwell EL, et al. Efficacy and tolerability of pegloticase for the treatment of chronic gout in patients refractory to conventional treatment: two randomized controlled trials. JAMA. 2011;306:711–20.CrossRefPubMed

11.

Becker MA, Schumacher Jr HR, Wortmann RL, MacDonald PA, Palo WA, Eustace D, et al. Febuxostat, a novel nonpurine selective inhibitor of xanthine oxidase: a twenty-eight-day, multicenter, phase II, randomized, double-blind, placebo-controlled, dose-response clinical trial examining safety and efficacy in patients with gout. Arthritis Rheum. 2005;52:916–23.CrossRefPubMed

12.

Wallace SL, Robinson H, Masi AT, Decker JL, McCarty DJ, Yu TF. Preliminary criteria for the classification of the acute arthritis of primary gout. Arthritis Rheum. 1977;20:895–900.CrossRefPubMed

13.

Khanna D, Khanna PP, Fitzgerald JD, Singh MK, Bae S, Neogi T, et al. 2012 American College of Rheumatology guidelines for management of gout. Part 2: therapy and antiinflammatory prophylaxis of acute gouty arthritis. Arthritis Care Res (Hoboken). 2012;64:1447–61.CrossRef

14.

Saad L. http://www.gallup.com/poll/156770/majority-drink-alcohol-averaging-four-drinks-week.aspx. Gallup Poll; 2012. Accessed 10 Mar 2017.

15.

Johnston CS, Tjonn SL, Swan PD. High-protein, low-fat diets are effective for weight loss and favorably alter biomarkers in healthy adults. J Nutr. 2004;134:586–91.PubMed

16.

Dessein PH, Shipton EA, Stanwix AE, Joffe BI, Ramokgadi J. Beneficial effects of weight loss associated with moderate calorie/carbohydrate restriction, and increased proportional intake of protein and unsaturated fat on serum urate and lipoprotein levels in gout: a pilot study. Ann Rheum Dis. 2000;59:539–43.CrossRefPubMedPubMedCentral

17.

Zhang Y, Chen C, Choi H, Chaisson C, Hunter D, Niu J, et al. Purine-rich foods intake and recurrent gout attacks. Ann Rheum Dis. 2012;71:1448–53.CrossRefPubMedPubMedCentral

18.

Zhang Y, Woods R, Chaisson CE, Neogi T, Niu J, McAlindon TE, et al. Alcohol consumption as a trigger of recurrent gout attacks. Am J Med. 2006;119:800 e13–8.CrossRefPubMed

19.

Richette P, Doherty M, Pascual E, Barskova V, Becce F, Castaneda-Sanabria J, et al. 2016 updated EULAR evidence-based recommendations for the management of gout. Ann Rheum Dis. 2017;76:29–42.CrossRefPubMed

Title: Sex differences in gout characteristics: tailoring care for women and men
Authors: Leslie R. Harrold
Carol J. Etzel
Allan Gibofsky
Joel M. Kremer
Michael H. Pillinger
Kenneth G. Saag
Naomi Schlesinger
Robert Terkeltaub
Vanessa Cox
Jeffrey D. Greenberg
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/s12891-017-1465-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Sex differences in gout characteristics: tailoring care for women and men

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Quantitative magnetic resonance imaging (MRI) analysis of anterior talofibular ligament in lateral chronic ankle instability ankles pre- and postoperatively

Monobloc implants in cementless total hip arthroplasty in patients with Legg-Calve-Perthes disease: a long-term follow-up

Posterior shoulder dislocation with associated reverse Hill-Sachs lesion: treatment options and functional outcome after a 5-year follow up

Evaluating non-responders of a survey in the Swedish fracture register: no indication of different functional result

The immediate effect of muscle release intervention on muscle activity and shoulder kinematics in patients with frozen shoulder: a cross-sectional, exploratory study

Functional midterm follow-up comparison of stemless total shoulder prostheses versus conventional stemmed anatomic shoulder prostheses using a 3D-motion-analysis