ARE THE CLINICAL CHARACTERISTICS OF GOUT CHANGING OVER TIME?

Background: according to the recent literature, gout seems to be changing its clinical spectrum, for it is now more frequently poliarticular, involves the hand, affects a wide range of age groups, and its incidence is increasing in women Objectives: to evaluate the clinical and laboratory characteristics of a cohort of 107 gout patients, divided according to the years of disease onset and of presentation at our Institution. Methods: the structured questionnaires of 107 consecutive patients with gout seen between 1989 and 2009 were retrospectively reviewed. Gout was diagnosed according to the ACR criteria. The following data were collected: a. demographic data including age, gender and family history of gout and psoriasis; b. history of present or previous comorbidities, including diabetes mellitus, hypertension, renal or gallbladder stones, renal insufficiency, cardiovascular or cerebrovascular ischemic events, hyperlipemia, and psoriasis; c. medications, including urate lowering agents (allopurinol, sulphinpirazone), anti-inflammatory agents (colchicine, NSAIDs, corticosteroids), and diuretics; d. clinical features of arthritis including time from the first attack, number of attacks, number and type of involved joints, presence of tophi; e. serum uric acid concentrations, ESR and C-reactive protein. Patients were divided according to the year of the first acute arthritis attack (median 2001) in two subgroups: those who experienced it between 1967 and 2001 or between 2002 and 2009. The same subgrouping was applied for the year of the first visit at our Institution (median 2006) with two groups resulting: 1989-2006 and 2007-2009. Results: the year of the first attack was evaluable in 92 (86%) patients and that of the first visit in 99 (92.5%). The male to female ratio changed from 11.3 in the patients who had the first attack within the year 2001 to 2.4 in those who experienced it after that year (p=0.02). A family history of gout was slightly more frequent in the subgroup with more recent disease onset (22.7% vs 6.4%, p=0.05). Conclusion: Our data suggest that the only relevant feature of gout that has changed in the considered period of time is the patients' sex ratio. Clinicians should be aware that gout is increasingly affecting women. Disclosure of Interest: None declaredCitation: Annals of the Rheumatic Diseases, volume 69, supplement 3, year 2010, page 605Session: Bone diseases other than osteoporosis, metabolic diseases and crystal diseases (Poster Presentations )