Gout not associated with increased risk of fracture, study finds

Gout, a painful inflammatory arthritis, is not associated with an increased risk of fracture, according to a large study led by Keele University, and published in CMAJ (Canadian Medical Association Journal).

These results contrast with those of previous studies, which found higher risk of fracture in people with gout.

Gout is the most common form of inflammatory arthritis, caused by the buildup of urate crystals in a joint. It can result in severe pain and swelling in joints, most often the base of the big toe but also in other joints. In the United Kingdom, 2.4% of adults are afflicted.

There is some evidence that chronic inflammation may increase the risk of fracture.

Researchers from Keele University conducted a study in the UK using a large primary care database. They included 31 781 patients with gout who were matched to 122961 controls and followed them for between 6.8 and 13.6 years until the first diagnosis of a fracture. The rate of fracture was similar in people with and without gout. In addition, medication to lower urate levels in people with gout did not appear to benefit or adversely affect the long-term risk of fractures.

"Our use of a nationally representative cohort should enable our study findings to be generalizable not only to the UK but also to other countries with similar health care systems," writes Dr. Zoe Paskins, Arthritis Research UK Primary Care Centre, Keele University, Staffordshire, UK.

The study was funded by the National Institute for Health Research (NIHR) School for Primary Care Research in the UK.

"Risk of fragility fracture among patients with gout and the effect of urate-lowering therapy" is published May 14, 2018.