ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2018
Risk of fragility fracture among patients with gout and the effect of urate-lowering therapy.
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 2 of them syntheses that pooled it.
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Who cites it
10 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association between gout and the risk of osteoporosis and fractures: a meta-analysis.Zeitschrift fur Rheumatologie · 2024Pooled it
- Gout is not associated with the risk of fracture: a meta-analysis.Journal of orthopaedic surgery and research · 2019Pooled it
- Gout and allopurinol adherence in newly diagnosed patients and the risk of fractures: a nationwide cohort study.Clinical rheumatology · 2026Article
- Exploring Fall-Related Fracture Risk by Possible Fall-Risk Increasing Drugs in Japanese Older Adults Using Municipal Linked Medical and Long-Term Care Claim Data: A Nested Case-Control and Case-Crossover Study.Geriatrics & gerontology international · 2025Article
- Potential Association of Osteoporosis and Not Osteoporotic Fractures in Patients with Gout: A Longitudinal Follow-Up Study.Nutrients · 2022Article
- Case report of a tibial fracture in a patient suffering from gout: An atypical site, the importance of differential diagnosis.Radiology case reports · 2022Article
- MiR-214 regulates fracture healing through inhibiting Sox4 and its mechanism.Journal of musculoskeletal & neuronal interactions · 2020Article
- Global epidemiology of gout: prevalence, incidence, treatment patterns and risk factors.Nature reviews. Rheumatology · 2020Review
- The Paradoxical Role of Uric Acid in Osteoporosis.Nutrients · 2019Review
- Bimalleolar pathological fracture in a patient with chronic tophaceous gout.Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologieArticle
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Authors and funding
9 authors.
Funding
Abstract
backgroundPrevious studies that quantified the risk of fracture among patients with gout and assessed the potential effect of urate-lowering therapy have provided conflicting results. Our study aims to provide better estimates of risk by minimizing the effect of selection bias and confounding on the observed association.
methodsWe used data from the Clinical Practice Research Datalink, which records primary care consultations of patients from across the United Kingdom. We identified patients with incident gout from 1990 to 2004 and followed them up until 2015. Each patient with gout was individually matched to 4 controls on age, sex and general practice. We calculated absolute rate of fracture and hazard ratios (HRs) using Cox regression models. Among patients with gout, we assessed the impact of urate-lowering therapy on fracture, and used landmark analysis and propensity score matching to account for immortal time bias and confounding by indication.
resultsWe identified 31 781 patients with incident gout matched to 122 961 controls. The absolute rate of fracture was similar in both cases and controls (absolute rate = 53 and 55 per 10 000 person-years, respectively) corresponding to an HR of 0.97 (95% confidence interval 0.92-1.02). Our finding remained unchanged when we stratified our analysis by age and sex. We did not observe statistically significant differences in the risk of fracture among those prescribed urate-lowering therapy within 1 and 3 years after gout diagnosis.
interpretationOverall, gout was not associated with an increased risk of fracture. Urate-lowering drugs prescribed early during the course of disease had neither adverse nor beneficial effect on the long-term risk of fracture.
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