Gout is an extremely painful form of arthritis which can affect various joints in the body. During an acute attack, the joint and surrounding area becomes swollen and severely painful. We already know that people with gout are more likely to die younger than similar people without gout, and are particularly much more likely to die from heart disease. However, we are not sure whether they are also more likely to die from other conditions, such as diabetes and cancer. Using routinely collected health information from the Clinical Practice Research Datalink, we propose to assess whether people with gout are more likely to die of certain conditions than similar patients who do not have gout.
One in three patients with gout are prescribed long-term treatment to reduce high levels of uric acid found in their blood (which causes gout), but we do not know whether this medication has any influence on the age or cause of death of people with gout. Therefore, we will use data from the same sample of people to compare whether people with gout who are prescribed this medicine are more or less likely to die from specific conditions than people with gout who are not prescribed the medicine.
Gout is the most prevalent type of inflammatory arthritis in the UK, affecting 2.5% of adults and is responsible for premature mortality. Evidence describing causes of death among gout patients remains limited. Around 35% of patients with gout are prescribed urate lowering therapy (ULT). Whilst ULT improves outcomes in these patientsÂ’, its influence on cause-specific mortality remains unknown.
This project will quantify the risk of 1) all-cause and 2) cause-specific mortality among gout patients compared with the general population and 3) investigate the effect of ULT exposure on the risk mortality among gout patients.
For aim 1 and 2, we will use a retrospective matched cohort, identifying incident gout patients matched to four gout-free patients on gender, age, general practice and follow-up time. Risk of all-cause and cause-specific mortality will be compared between cases and controls using Cox regression models, obtaining hazard ratios and 95% confidence intervals. For aim 3, we will extract information on ULT exposure from the gout patients only. We will compare the risk of all-cause and cause-specific mortality between those prescribed at least 6 months ULT within a 1 and 3 year landmark exposure window following gout diagnosis, and those not prescribed ULT during that period.
Cause of death:
o Infection
o Cardiovascular disease
o Dementia
o Diabetes
o Neoplasm
o Renal
o All other causes
Rebecca Whittle - Chief Investigator - Keele University
Rebecca Whittle - Corresponding Applicant - Keele University
Alyshah Abdul Sultan - Collaborator - AstraZeneca Ltd - UK Headquarters
Christian Mallen - Collaborator - Keele University
Edward Roddy - Collaborator - Keele University
John Belcher - Collaborator - Keele University
Lorna Clarson - Collaborator - Not from an Organisation
Trishna Rathod-Mistry - Collaborator - Keele University
ONS Death Registration Data;Practice Level Index of Multiple Deprivation