Cardiovascular events in patients with gout initiating urate-lowering therapy with or without colchicine for flare prophylaxis: a retrospective new-user cohort study using linked primary care, hospitalisation, and mortality data
Authors' conclusion
In patients with gout initiating urate-lowering therapy, the risk of cardiovascular events was reduced in those prescribed colchicine prophylaxis compared with no prophylaxis.
Study context
- Population
- People with gout initiating ULT for the first time, Clinical Practice Research Datalink Aurum (English primary care linked to hospitalisation and mortality records)of 111,460 eligible
- Participants
- 99,800 people
- Exposure
- Colchicine flare prophylaxis vs no flare prophylaxis at initiation of ULT
- Colchicine prophylaxisn = 16,028
- Outcome
- Composite of:
- Fatal and non-fatal MI or stroke
- Regardless of any previous cardiovascular event
- Follow-up
- Within 180 days after ULT initiation
Methodological detailsnew-user cohort, propensity score overlap weighting, Cox regression, intention-to-treat and per-protocol analyses, Members of The UK Gout Society were involved in prioritising the research question
- New-user cohort
- Propensity score overlap weighting
- Cox regression
- Intention-to-treat and per-protocol analyses
- Members of The UK Gout Society were involved in prioritising the research question
Main finding
As reported in the abstract
Cardiovascular events (fatal/non-fatal MI or stroke), weighted rate · 180 days
Each group vs no prophylaxisWeighted rate difference, per 1000 person-years (95% CI)
Colchicine prophylaxis
−6.5(−9.4 to −3.6)
Each group vs no prophylaxisWeighted hazard ratio (95% CI)
Colchicine prophylaxis
0.82(0.69–0.94)
Observational data: associations, not effects.
Secondary outcomes
Other analytical approaches, stratified analyses and secondary outcomes
- Findings were similar across analytical approaches, stratified analyses, and for secondary outcomes
Original publication
Cardiovascular events in patients with gout initiating urate-lowering therapy with or without colchicine for flare prophylaxis: a retrospective new-user cohort study using linked primary care, hospitalisation, and mortality data. Lancet Rheumatol. Published 18 December 2024. doi:10.
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