Chances of Developing Gout Are Higher for Patients With IBD

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Data from a new study suggest a diagnosis of inflammatory bowel disease (IBD) could signal increased risk of developing gout later in life.

Results of the study, which examined the prevalence of gout among more than 200,000 US adults diagnosed with Crohns disease (CD) and ulcerative colitis (UC), results of the study suggest patients with CD had a 68% increase in likelihood of developing gout while those with UC experienced a 38% increase in likelihood of gout relative to their counterparts without IBD.

“To the best of our knowledge, this is the first large-scale database study to bring out this relationship,” wrote study investigators.

Associated with an increased risk of chronic disease and impacting an estimated 3 million US adults, IBD represents an often-overlooked risk to public health. As knowledge of inflammatory pathways has progressed, links between IBD and different forms of arthritis have become a focal point for many research efforts. In the current study, Osama Hamid, MBBS, a medical resident with Cape Western Reserve University, and a team of colleagues sought to estimate the prevalence of gout among patients with IBD using real-world data.

With this in mind, investigators designed their study as an analysis of data obtained from the Explorys Inc database, which provided investigators with information related to 69,260,780 patients who received care between 1999 and 2022. Of the more than 69 million within the database, investigators identified 458,500 patients diagnosed with IBD.

Of these 458,500 individuals, 209,020 with UC and 249,480 with CD. Among those with UC, 9130 patients had gout, which correlates to a prevalence rate of 4.3% compared to 3.51% among those in the general population with no history of UC (P < .001). Among those with CD, 14,000 had gout, which correlates to a prevalence rate of 5.61% compared to 3.53% among the general population without a diagnosis of CD (P < .001). Of note, among the 69,260,780 patients identified within the Explorys Inc. database, 2,400,990 had gout with no IBD.

Upon analysis, results indicated the majority of patients in both UC with gout and CD with gout were more than 65 years old, males made up the majority of patients in both groups, and more than 80% of each group were Caucasian. In analyses adjusted for demographic information and gout risk factors, results suggested a diagnosis of CD was associated with a 68% increase in likelihood of developing gout (Odds Ratio [OR], 1.68; Confidence Interval [CI], 1.60-1.75; P < .001). Similarly, a diagnosis of UC was associated with a 38% increase in likelihood of developing gout in adjusted analyses (OR, 1.38; 95% CI, 1.31-1.44; P < .001).

Investigators also called attention to a subgroup analysis in both groups against intestinal resection. In this analysis, the UC group with intestinal resection appeared to have a greater likelihood of developing gout than those who did not have surgery (OR, 2.34; 95% CI, 2.25-2.43; P < .001). For those with CD, a similar increase in likelihood was observed among those who had intestinal resection relative to those with no surgery (OPR, 1.53; 95% CI, 1.49-1.56; P < .001).

“This exploratory analysis of a large database study suggests a strong association between IBD and gout. Several pathophysiological mechanisms could be contributory to this relationship. IBD-related intestinal resection is a significant risk factor for gout in this patient population. We recommend that patients with IBD who present with new-onset arthritis be carefully investigated for gout,” investigators concluded.