Predicting Gout Flares in People Starting Allopurinol Using the Start‐Low Go‐Slow Dose Escalation Strategy
Authors' conclusion
Anti-inflammatory prophylaxis when starting allopurinol using the "start-low go-slow" dose escalation strategy may be best targeted at those who have had a gout flare in the month before starting allopurinol and are commencing allopurinol 100 mg daily.
Study context
- Population
- People with gout commencing allopurinol using the "start-low go-slow" dose escalation strategy
- Comparison
- Predictors of gout flare when commencing allopurinol (start-low go-slow); trial arms colchicine 0.5 mg daily vs placebo for the first 6 months
- Primary endpoint
- Predictors of gout flares in the first and last six months of the trial
- Follow-up
- First six months; last six months
Methodological detailsdouble-blind, placebo-controlled, noninferiority, 12-month, multivariable logistic regression
- Double-blind
- Placebo-controlled
- Noninferiority
- 12-month
- Multivariable logistic regression
Primary result
As reported in the abstract
Independent predictors of gout flare in the first six months (multivariable analysis)
Flare in the month before starting allopurinol, OR
2.65 (1.36-5.17) (95% CI)
Allopurinol 100 mg starting dose, OR
3.21 (1.41-7.27) (95% CI)
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Predictors of any gout flares in the last six months, after stopping colchicine or placeboHaving received colchicine | 2.95 (1.48–5.86) | |
| 0.20.5125Odds ratio (log scale) |
- Predictors of any gout flares in the last six months, after stopping colchicine or placebo — At least one flare in the month before stopping study drug, OR
- 5.39 (2.21-13.15) (95% CI)
- Predictors of any gout flares in the last six months, after stopping colchicine or placebo — Serum urate ≥0.36 mmol/L at month 6, OR
- 2.85 (1.14-7.12) (95% CI)
Original publication
Predicting Gout Flares in People Starting Allopurinol Using the Start‐Low Go‐Slow Dose Escalation Strategy. Arthritis Care Res (Hoboken). Published 5 June 2024. doi:10.
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