Elevated serum CA72-4 predicts gout flares during urate lowering therapy initiation: a prospective cohort study
Authors' conclusion
High serum CA72-4 predicts the risk of gout flares during ULT initiation.
Study context
- Population
- Men with gout, ≥1 gout flare in the past year and ≥3 serum CA72–4 measurements in the previous six months, starting febuxostat 20 mg daily without flare prophylaxiscompleted the study
- Participants
- 193 men
- Exposure
- High serum CA72-4 vs normal serum CA72-4
- High CA72-4n = 79
- Normal CA72-4n = 114reference
- Outcome
- Incidence of gout flare (at least one gout flare) during urate-lowering therapy (ULT) initiation
- Follow-up
- 24 weeks
Methodological detailsbackward stepwise logistic regression, ROC curve analysis, March 2021 to January 2022; visits every four weeks until 24 weeks
- Backward stepwise logistic regression
- ROC curve analysis
- March 2021 to January 2022; visits every four weeks until 24 weeks
Main finding
As reported in the abstract
Cumulative incidence of at least one gout flare
P = 0.001
- Overall cumulative incidence of at least one gout flare
- 48.1%
Observational data: associations, not effects.
Further findings
Recurrent (≥2) gout flares, cumulative incidence · 24 weeks
P < 0.001
- Recurrent (≥2) gout flares, cumulative incidence — Overall cumulative incidence of recurrent flares
- 33.0%
Independent risk factors for gout flares (backward stepwise logistic regression)
- High CA72-4, disease duration, intra-articular tophus size, glucose, HDL-cholesterol and ESR were independent risk factors for gout flares
Prediction of recurrent flares (ROC analysis)
- Serum CA72-4 alone, AUC
- 0.63 (95% CI 0.54, 0.71)
- Serum CA72-4 combined with other independent variables, AUC
- 0.78 (95% CI 0.71, 0.85)
Original publication
Elevated serum CA72-4 predicts gout flares during urate lowering therapy initiation: a prospective cohort study. Rheumatology (Oxford). Published 21 November 2022. doi:10.
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