Credit: Original article published here.
A recent study published in the Epidemiology aimed to investigate the cardiovascular safety of intensive treat-to-target serum urate strategies for gout utilizing Medicare claims data linked to electronic health record laboratory data.
Urate-lowering therapy is a commonly used treatment for gout, and the study sought to assess the risk of major adverse cardiovascular events (nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death) associated with different strategies for urate-lowering therapy.
The study selected patients with gout who initiated urate-lowering therapy and emulated a hypothetical trial comparing the rate of major adverse cardiovascular events among 7 different strategies over 24 months. “Three aspects were considered in defining increasingly intensive strategies,” the researchers stated, including “continuation of urate-lowering therapy, serum urate monitoring, and modification of urate-lowering therapy when serum urate [is] >6mg/dL.”
The clone-censor-weight method was applied to account for baseline and time-varying confounding. The study identified 4402 patients with gout who initiated urate-lowering therapy. Patients had a mean age of 77 years and were 60% male.
Over the course of 6611 person-years of follow-up under usual care, the rate of major cardiovascular events was found to be 4.5 per 100 person-years. The rate ratios indicated a decrease in the occurrence of cardiovascular events as compared with usual care. Although the 95% confidence intervals were imprecise, their upper bounds did not allow for a significant increase in the rate ratios.
“Our treatment strategy trial emulation did not find increased risk of major adverse cardiovascular events with intensive urate-lowering strategies. Results may provide reassurance of the cardiovascular safety of intensive treat-to-target serum urate strategies recommended by rheumatology societies,” the researchers concluded.
Source: Epidemiology
