Risk of Venous Thromboembolism With Gout Flares

Abstract

ObjectivePrevious studies demonstrated that the risk of venous thromboembolism (VTE) is increased in patients with gout, but not whether there was a temporal association between gout flare and VTE. This study was undertaken to evaluate potential temporal associations between gout flare and VTE.MethodsData were obtained from electronic primary‐care records from the UK's Clinical Practice Research Datalink, which links data from hospitalization and mortality registers. Using self‐controlled case series analysis adjusted for season and age, we evaluated the temporal association between gout flare and VTE. The 90 days after primary‐care consultation or hospitalization for gout flare was designated the exposed period. This was divided into three 30‐day intervals. The baseline period was up to 2 years before the start of and up to 2 years after the end of the exposed period. The association between gout flare and VTE was measured using adjusted incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs).ResultsIn total, 314 patients met the inclusion criteria (age ≥18 years, incident gout, no presence of VTE or use of a primary‐care anticoagulant prescription before the start of the pre‐exposure period). Among the 314 patients, VTE incidence was significantly higher in the exposed period than in the baseline period (adjusted IRR 1.83, 95% CI 1.30–2.59). The adjusted IRR of VTE during the first 30 days after gout flare was 2.31 (95% CI 1.39–3.82) relative to the baseline period. No increase in the adjusted IRRs was observed in days 31–60 (adjusted IRR 1.49, 95% CI 0.79–2.81) and days 61–90 (adjusted IRR 1.67, 95% CI 0.91–3.06) relative to baseline. Results were consistent across sensitivity analyses.ConclusionAmong patients with gout, there was a transient increase in the rate of VTE within 30 days after primary‐care consultation or hospitalization for gout flare.