Patients With Early-Onset Gout and Development of Earlier Severe Joint Involvement and Metabolic Comorbid Conditions: Results From a Cross-Sectional Epidemiologic Survey.

Abstract

Little is known of the clinical features and comorbidity profile of patients presenting with early-onset gout (EOG), although international guidelines recommend rapid treatment after diagnosis. The objective of this study was to assess specific characteristics and comorbidities of patients with gout who had an early onset. Patients from a cross-sectional French national cohort who experienced their first gout flare before age 40 years were included in the EOG group and compared to patients with an onset after age 40 years, the common gout group. A total of 120 patients were included in the EOG group (mean ± SD age 49.5 ± 11.9 years) and 865 patients in the common gout group (mean ± SD age 64.4 ± 10.1 years). Patients with EOG more often presented with a history of polyarticular flares (P < 0.01), but had similar frequency of flares (P = 0.16), gout arthropathy (P = 0.79), and tophi (P = 0.53). Prevalence of each item comprising metabolic syndrome did not differ between groups. In patients with EOG, all cardiovascular comorbidities were diagnosed after gout onset. Greater age, low high-density lipoprotein, and excessive alcohol intake were associated in multivariate analysis with the common gout group, while a familial history of gout, longer duration of urate-lowering treatment, higher serum uric acid levels, and metabolic syndrome were associated with the EOG group. Patients with EOG developed slightly more severe joint involvement and earlier metabolic disorders than patients with common gout.