Rheumatology

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Frequency, risk, and cost of gout-related episodes among the elderly: Does serum uric acid level matter?
Journal of Rheumatology, 05/18/09

Wu EQ et al. – Study provides evidence that the higher serum uric acid (SUA) levels are associated with increased frequency and risk of gout episode, and with higher total and gout-related direct healthcare costs per episode.

• Aim was to examine the association between SUA level and the frequency, risk, and cost of gout flares among the elderly
• Data extracted from the Integrated Healthcare Information Services claims database (1999–2005)
• Patient's inclusion criteria:
  • if they had gout
  • were aged 65 yrs and older and
  • had both medical and pharmacy benefits, and electronic laboratory data
• Pts with gout and gouty episodes were identified using algorithms based on ICD-9-CM codes and medications

• Elderly pts with gout (n=2237) with high (6–8.99 mg/dl) and very high (>9 mg/dl) SUA concns were more likely to develop a flare within 12 mo vs pts with normal SUA levels
• Multivariate regressions analysis: average annual number of flares increased by 11.9% with each unit-increase in SUA level above 6 mg/dl
• Among pts with very high SUA levels, average adjusted total healthcare and gout-related costs per episode were $2,555 and $356 higher, respectively, vs those with normal SUA levels

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