medwire news: Results of a prospective cohort study suggest that elevated serum CA72-4 levels at initiation of uric acid-lowering therapy (ULT) are an independent risk factor for recurrent gout flares.
This study included 193 men with gout (mean age 45.3 years) who were started on oral febuxostat 20 mg daily without flare prophylaxis. Participants who had in-person visits every 4 weeks during the 24-week follow-up had a median disease duration of his 7.0 years. All had at least 1 relapse in the last 12 months and had at least 3 serum CA72-4 measurements in the last 6 months.
Changgui Li (Qingdao University Hospital, China) and colleagues divided individuals into two groups based on whether their highest recorded serum CA72-4 levels exceeded the upper limit of normal. Overall, 79 patients had her CA72-4 readings above 6.9 U/mL and were included in the ‘high’ group, her other 114 were assigned to the ‘normal’ arm. rice field.
Overall, the cumulative incidence of at least one gout flare was 48.1% and the incidence of recurrent (at least two) flares was 33.0%. Comparing both groups, the overall relapse rate was significantly higher in those with high and low CA72-4 levels, 62.1% vs. 38.4%, and the relapse rate was 47.1% vs. 23.2%.
Using multivariate analysis, the researchers found that, with an odds ratio of 2.34, higher CA72-4 levels, larger intra-articular nodule size, longer disease duration, and increased erythrocyte sedimentation rate were associated with the risk of recurrent gout flares. showed that it was significantly and independently associated with increase. 1.97, 1.08, and 1.06 respectively. On the other hand, elevated glucose and high-density lipoprotein cholesterol levels were associated with reduced risk, with corresponding odds ratios of 0.51 and 0.13.
write in Rheumatology, the team reported that high serum CA72-4 levels at the start of ULT predicted gout recurrence during follow-up with 63% accuracy. Furthermore, when high CA72-4 was combined with other independent risk factors identified in the study, the accuracy of predicting recurrent gout flares improved to 78%.
These results “suggest the possibility of stratifying patients who may benefit from gout prophylaxis treatment,” and that “monitoring dynamic changes in CA72-4 may lead to anti-inflammatory It may allow us to use prophylactic drugs more rationally,” the researchers said.
However, Li et al. stated, “Because all subjects in this study were male and Chinese, it is unclear whether the association between CA72-4 and gout flares can be extended to women or other ethnic groups.” I’m here.
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