Gout patients do not have enhanced resistance to infections

01 Jun 2017
Gout patients do not have enhanced resistance to infections

The presence of gout does not appear to reduce the risks of pneumonia, urinary tract infection (UTI) or infection-related mortality in patients when compared with population-based controls, according to a retrospective cohort study.

To test the hypothesis that patients with gout may acquire fewer community-acquired infections, researchers analysed data on 131,565 gout patients and 252,763 healthy controls (mean age 64 years; 74 percent males) drawn from the UK Clinical Practice Research Datalink. Mean follow-up duration was 6.7 years. The risks of infections and mortality were estimated using time-varying Cox proportional hazards models.

Compared with controls, gout patients had increased risk of pneumonia (adjusted hazard ratio [HR], 1.27; 95 percent CI, 1.18 to 1.36). The risk of UTI, however, was similar between the two groups (adjusted HR, 0.99; 0.97 to 1.01). Patients and controls also had similar infection-related mortality due to pneumonia (adjusted HR, 1.03; 0.93 to 1.14) or UTI (adjusted HR, 1.16; 0.98 to 1.37).

Gout is a chronic disease with different manifestations, ranging from acute self-limiting attacks to chronic tophaceous gout. The presence of a proinflammatory state-associated hyperuricaemia has brought about the hypothesis that gout patients may have an enhanced resistance to infections, with previous studies reporting that IL-1bèta augments the quality of host defence against bacteria and viruses. [Lancet 2010;375:318–328; Ann Rheum Dis 2016;75:755–762]

The findings show that, contrary to the hypothesis, gout patients have an increased risk of pneumonia and UTI, although the excess in the risk of the latter may be attributed to classic risk factors, researchers said. “Therefore, the clinical relevance of these findings remain unclear and the effects seem small.”

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