Obesity reduces the urate-lowering efficacy among patients with primary gout: a prospective cohort study
Authors' conclusion
Obesity significantly reduces the efficacy of febuxostat-based ULT in male gout patients rather than being overweight.
Study context
- Population
- Men with primary gout receiving febuxostat 20 to 40 mg daily for 12 weeksmen with gout
- Participants
- 633 men
- Exposure
- Obese vs overweight vs normal-weight men with gout, all receiving febuxostat
- Outcome
- Proportion achieving SU < 6.0 mg/dl
- Follow-up
- Week 12
Methodological detailsmatched on baseline age, disease duration and serum urate, Cox regression, restricted cubic spline
- Matched on baseline age, disease duration and serum urate
- Cox regression
- Restricted cubic spline
Main finding
As reported in the abstract
SU < 6.0 mg/dl achieved
P < 0.05
Observational data: associations, not effects.
Further findings
High BMI as risk factor for achieving serum urate (SU) target (Cox regression)
| HR (95% CI) | P value | ||
|---|---|---|---|
| High BMI | 0.92 (0.89–0.96) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
- High BMI as risk factor for achieving SU target (Cox regression): independently prevented achieving the SU target; similar effect after matching
Cumulative incidence of gout flares
- Obese and overweight higher cumulative incidence of gout flares vs normal-weight
- P < 0.05
Relationship between BMI and HR for achieving SU target (restricted cubic spline (RCS))
- Linear relationship suggested
- nonlinear P > 0.05
Safety
| Outcome | P value |
|---|---|
| Cumulative incidence of gout flaresObese and Overweight vs Normal-weight · higher in obese and overweight | P < 0.05 |
Original publication
Obesity reduces the urate-lowering efficacy among patients with primary gout: a prospective cohort study. Rheumatology (Oxford). Published 10 February 2025. doi:10.
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