To the Editor:
We thank Huang and colleagues1 for their interest in our study on the changes in the presentation of incident gout and the risk of subsequent flare1. We reported changes over time in gout presentation with podagra becoming less frequent, whereas hyperuricemia and chronic kidney disease were predictors of future flares2.
Our group previously reported the risk of in-hospital flares in patients with incident gout, where we reported a 10-fold increase in gout flares during hospitalization3. In that analysis, discontinuation of urate-lowering therapy (ULT) was not significantly associated with increased risk of in-hospital flare (OR 0.86; 95% CI 0.11-6.83).
Huang and colleagues have reported an increased risk of flares in the postdischarge period when ULT was discontinued in their patient population1. These findings augment our prior study of hospitalized patients with gout in showing that not only is the risk of flares increased during the hospital stay, but the increased risk may extend to the posthospitalization period and up to 3 months after discharge. Increasing awareness about the effect of discontinuing ULT among general practitioners and internists is of great importance to avoid preventable flares in patients with gout4.
Footnotes
This work was made possible using the resources of the Rochester Epidemiology Project, which is supported by the US National Institute on Aging of the National Institutes of Health (NIH) under Award Number R01AG034676 and Clinical and Translational Science Awards Grant Number UL1 TR000135 from the National Center for Advancing Translational Sciences, a component of the NIH. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
- Copyright © 2021 by the Journal of Rheumatology