NEW YORK – Patients with gout who took colchicine had less than one-half the risk of having a myocardial infarction that was seen in patients who were untreated for their gout. But this protective effect was not seen for patients taking allopurinol, Dr. Michael Pillinger, a coauthor of the study, said at a rheumatology meeting sponsored by New York University.
In this retrospective analysis of data from 1,300 patients from the New York Veterans Affairs Gout Cohort, about 0.5% of those taking colchicine had an MI, compared with 3% of those not taking any antigout medication (P less than .05). The MI rate for those taking allopurinol was slightly more than 2%, which was not significantly different from the rate in the untreated group. A significant reduction was seen for those taking both colchicine and allopurinol. Death rates were comparable among the groups.
"When we stepped out of the database and read the charts, we found [that] several of the patients who were categorized as having MIs on colchicine actually had been put on colchicine after their MI, so when we corrected for this, the difference was even greater," said Dr. Pillinger, director of the rheumatology fellowship program at New York University and director of rheumatology at the Manhattan campus of the VA New York Harbor Healthcare System.
"These are very provocative findings," he added. His group is currently undertaking more rigorous retrospective analyses and hopes to begin a prospective study.
Dr. Pillinger postulated that the lack of significant effect of allopurinol was due to its inconsistency in lowering urate levels. "In our hands, allopurinol does not always reduce urate levels," he noted.
These data confirm findings from an earlier study by Dr. Pillinger and his associates that looked at 45,000 Taiwanese men with hyperuricemia or gout. Those findings showed that treating hyperuricemia and gout could help control comorbid cardiovascular disease.
Dr. Pillinger reported financial relationships with Takeda (the study site) and URL Pharma (an investigator-initiated grant).