Low-dose aspirin use and recurrent gout attacks.
OBJECTIVE
To examine the association between cardioprotective use of low-dose aspirin and the risk of recurrent gout attacks among gout patients.


METHODS
We conducted an online case-crossover study of individuals with gout over 1 year. The following information was obtained during gout attacks: the onset dates, symptoms and signs, medications, and exposure to potential risk factors, including daily aspirin use and dosage, during the 2-day hazard period prior to the gout attacks. The same exposure information was also obtained over 2-day control periods.


RESULTS
Of the 724 participants analysed, 40.5% took aspirin ≤325 mg/day during either a hazard or a control period. Compared with no aspirin use, the adjusted OR of gout attacks increased by 81% (OR=1.81, 95% CI 1.30 to 2.51) for ≤325 mg/day of aspirin use on two consecutive days. The corresponding ORs were stronger with lower doses (eg, OR=1.91 for ≤100 mg, 95% CI 1.32 to 2.85). These associations persisted across subgroups by sex, age, body mass index categories and renal insufficiency status. Concomitant use of allopurinol nullified the detrimental effect of aspirin.


CONCLUSIONS
Our findings suggest that the use of low-dose aspirin on two consecutive days is associated with an increased risk of recurrent gout attacks. Recommended serum urate monitoring with concomitant use and dose adjustment of a urate-lowering therapy among patients with gout may be especially important to help avoid the risk of gout attacks associated with low-dose aspirin.
Clinical Epidemiology Research and Training Unit, Department of Medicine, Boston University School of Medicine, , Boston, Massachusetts, USA.
Yuqing
Y
Zhang
Tuhina
T
Neogi
Clara
C
Chen
Christine
C
Chaisson
David J
DJ
Hunter
Hyon
H
Choi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002316:Cardiotonic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006073:Gout / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D018570:Risk Assessment / Q000379:methods; D012959:Socioeconomic Factors; D055815:Young Adult
D002316:Cardiotonic Agents; D001241:Aspirin
Epidemiology; Gout; Treatment