PARIS – Women have different predisposing risk factors for gout than do men, who more often fit the stereotypical profile of patients with gout who consume foods that increase the risk of the disease.
In the study based on data collected from participants in the Consortium of Rheumatology Researchers of North America (CORRONA) gout registry, women with gout were more likely to have taken predisposing medications and to have more gout-associated comorbidities, whereas men were more likely to consume foods linked to the disorder, such as alcohol and red meat, according to Dr. Leslie Harrold, scientific director of the CORRONA gout registry.
Dr. Leslie Harrold
"We live in an era of personalized medicine," she said in an interview. "These findings speak to the need to tailor our evaluations and treatments based on the patient. There cannot be a one-size-fits-all approach. We need to approach women with gout differently than men with gout."
Patients in the gout study were enrolled in 2012-2013. Data gathered from patients and their rheumatologists at study enrollment included demographics, predisposing factors (comorbid conditions, medications, diet), gout disease characteristics, current treatments, and physical exam findings.
The 54 participating rheumatologists enrolled 1,167 gout patients (239 women). Women were significantly older than men (71 years vs. 61 years) and had higher body mass index (34 kg/m2 vs. 23 kg/m2). They also were significantly more likely to have hypertension (77% vs. 57%), diabetes (28% vs. 17%), and renal disease (25% vs. 14%).
Women also had a shorter duration of gout when enrolled (6 years vs. 11 years) and were less likely to have a crystal-proven diagnosis (26% vs. 35%).
Medication risk factors for gout, such as diuretics, were more common in women (49% vs. 22%), while dietary risk factors were more frequent in men, who consumed significantly more beer, hard liquor, beef, and pork, Dr. Harrold reported at the annual European Congress of Rheumatology.
Although the clinical features of gout were similar between the genders at the time of initial diagnosis, women reported more frequent disability. Women were more likely to have contraindications to treatment with NSAIDs or colchicine, but women with tophi or active disease – defined as two or more flares per year – used urate-lowering therapy at a rate that was not statistically different from men (78% vs. 84%).
"I think what is most interesting is that the profile of men and women with gout differs," said Dr. Harrold of the division of rheumatology at the University of Massachusetts, Worcester. "Doctors usually have a single concept of the typical patient. But instead, here we have to realize that the typical woman with gout is different than the typical man with gout. That should frame our evaluation of suspected cases."
A number of pharmaceutical companies have financially supported the CORRONA registry. In the last 5 years, Dr. Harrold has received research funding from Takeda and has a pending grant with AstraZeneca.