Latourte A, et al. - Factors associated with poor control of serum uric acid (UA) levels were investigated in a large population of patients with gout receiving urate-lowering therapy (ULT). The main factors associated with a poor response to ULT included dyslipidemia, abdominal obesity, and alcohol consumption. Identifying these factors might assist physicians in recognizing cases of gout that may be less likely to achieve target urate level.

Methods

• Adults with gout in primary care who were receiving ULT were included in this cross-sectional study.
• Researchers compared demographics, gout history, comorbidities, lifestyle, clinical factors, concomitant treatments, and laboratory data in well-controlled gout (serum UA ≤6.0 mg/dl) vs poorly controlled gout (serum UA >6.0 mg/dl) on univariate and multivariate analyses.

Results

• Researchers identified 1,995 patients who were receiving ULT.
• Among these, only 445 (22.3%) had reached the target of 6.0 mg/dl serum UA; these patients displayed a lower rate of gout flares within the previous year than patients without the target (mean ± SD 1.7 ± 1.4 vs 2.1 ± 1.4; P < 0.0001).
• Multivariate analysis revealed low high-density lipoprotein cholesterol level (adjusted odds ratio [OR] 0.5 [95% confidence interval (95% CI) 0.26–0.96]; P=0.04), high total cholesterol level (OR 1.83 [95% CI 1.29–2.60]; P=0.0007), increased waist circumference (OR 1.55 [95% CI 1.11–2.13]; P=0.008), and alcohol consumption (OR 1.52 [95% CI 1.15–2.00]; P=0.003) as the main factors associated with poor serum UA level control.