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The Study

Failure to reach uric acid target of <0.36 mmol/L in hyperuricaemia of gout is associated with elevated total and cardiovascular mortality

In simple terms

This study watched a group of people with gout for many years and noticed that those whose uric acid stayed high were more likely to die. But it didn’t make anyone change their uric acid — it just watched what happened. So we can’t say for sure that lowering uric acid will save lives — only that it’s linked to living longer.

72%

Analysis score

72/ 72

Maximum 72 for a cohort study.

Where the score came from

Reporting75
Methodology56
Publication100
Statistical77
Study type (basis of the score)
Cohort Study
Level 2b - Individual cohort study
What’s the bottom line?

People with gout who keep their blood uric acid below a certain level (0.36 mmol/L) are much less likely to die from heart problems or other causes.

Where does this study sit?

Reviews of RCTs (Meta-analyses)

Max 100

Randomized Trials

Max 90

Reviews of Cohort Studies

Max 85

Cohort Studies

Max 72

Reviews of Case-Control Studies

Max 63

Case-Control Studies

Max 58

Cross-Sectional & Case Series

Max 50

Expert Opinion

Max 5
StrongerWeaker
Cohort Studies
Level 2b
72

72 / 100

Quality score

Groups of people are followed over time to see who develops an outcome. Strong for identifying risk factors and associations, but cannot prove causation as firmly as RCTs.

Cannot establish causation

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Key takeaways

Summary

Based on the study abstract and findings.

  1. 1Yes — this means for every 1000 gout patients who don’t control their uric acid, about 81 die each year, compared to only 26 who do — a huge difference in survival.
  2. 2Those who kept uric acid below 0.36 mmol/L had 25.7 deaths per 1000 people per year; those who didn’t had 80.9 deaths per 1000 people per year — over 3 times higher.

Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data

Publication

Journal

RMD Open

Year

2019

Authors

F. Perez Ruiz, P. Richette, A. Stack, R. Karra Gurunath, M. J. García de Yébenes, L. Carmona

Open Access
62 citations
Analysis v6

Related Content

Claims (6)

Assertion

When serum uric acid levels are below 0.36 mmol/L, gout is considered under control, and patients do not need to continue taking high doses of allopurinol.

Descriptive
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Assertion

Patients with gout who do not lower their blood uric acid below 0.36 mmol/L within one year have more than twice the risk of dying from any cause or from cardiovascular disease compared to those who do, even after accounting for age, other health conditions, disease severity, and prior heart problems.

Correlational
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Assertion

Patients with gout who do not lower their blood uric acid below 0.36 mmol/L have more than twice the risk of dying from cardiovascular disease compared to those who do, even when accounting for age, existing heart problems, high blood pressure, diabetes, and kidney function.

Correlational
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Assertion

In people with gout, those who died were more likely to have had high levels of uric acid in their blood (above 0.36 mmol/L) than those who survived.

Correlational
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Assertion

In people with gout, those who lower their blood uric acid below 0.36 mmol/L have a lower death rate per year compared to those who do not reach this level.

Quantitative
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Assertion

Patients with gout who maintain a serum uric acid level below 0.36 mmol/L have a 2.33 times lower risk of dying from any cause than those who do not achieve this level, regardless of their initial uric acid levels, how long they have had gout, or other health conditions.

Correlational
Read analysis
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Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.