Rheumatology Medical News about Glucocorticoid, Tophi, Gouty

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Does prolonged systemic glucocorticoid use increase risk of tophus formation among gouty arthritis patients?
International Journal of Rheumatic Diseases, 08/19/09

Raso AAP et al. – Data demonstrate that patients with equivalent prednisone intake of at least 15 mg/wk for ≥3 months is associated with tophi formation among male gout pts. In the presence of hypertension, renal impairment, and elevated serum creatinine level, use of steroids confounds the individual risk that each factor carries.

Methods

Aim was to determine the relationship of steroid use with tophus formation and other comorbid conditions among male gout pts
Review of medical records of Filipino gout pts
Univariate analysis and multiple logistic regression analysis performed to establish the risk for tophus formation among glucocorticoid users
Bivariate analysis to determine the confounding effect of steroid use in the association of comorbidities and tophi formation

Results

295 Filipino men; mean age: of 56 yrs; mean duration of 12 yrs
Multivariate analysis: 5x higher likelihood for tophus formation among prolonged steroid users
Confounders identified:
- Disease duration of gout (≥10 yrs)
- Presence of chronic kidney disease (CKD), and
- Elevated serum creatinine level (SCr)
Bivariate analysis: steroid use introduced a considerable bias in the relationship of hypertension, elevated SCr, CKD and dyslipidemia

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