Joint Bone Spine. 2026 Oct 31:106156. doi: 10.1016/j.jbspin.2026.106156. Online ahead of print.
ABSTRACT
OBJECTIVE: To determine the prevalence and factors associated with coexisting gout in rheumatoid arthritis (RA) and evaluate whether concomitant gout is associated with worse RA disease activity.
METHODS: We conducted a retrospective study of RA patients enrolled in the Ontario Best Practices Research Initiative, a multicentre real-world cohort across Ontario, Canada. Coexisting gout was defined by patient- or physician-reported diagnosis or xanthine oxidase inhibitor use. Multivariable logistic regression identified factors associated with coexisting gout and the impact of gout on oral glucocorticoid (GC) use. The association between baseline gout and longitudinal RA disease activity (Clinical Disease Activity Index, CDAI ≤10) was examined using mixed-effects logistic regression at 24-months, adjusting for prespecified confounders.
RESULTS: Among 3,703 RA patients, 113 (3.1%) had coexisting gout with mean (SD) age of 66.1 (8.7) years and 52.2% were female. Coexisting gout was associated with older age (OR 1.05 per year), obesity (OR 1.67), cardiovascular disease or hypertension (OR 1.95) and diuretic use (OR 1.68), while female sex was inversely associated (OR 0.31). CDAI scores were similar between patients with and without gout at baseline (18.3±12.5 vs 20.2±13.5) and at 12-months (10.9±9.8 vs 11.0±10.4). After adjustment, baseline coexisting gout was neither significantly associated with oral GC use at 12-months (OR 1.73, 95% CI: 0.96-3.13) or the attainment of CDAI low disease activity/remission by 24-months (OR 1.19, 95% CI: 0.72-1.97).
CONCLUSION: In this large real-world RA cohort, coexisting gout was uncommon and associated with traditional gout risk factors but did not statistically influence oral GC use or RA treatment target attainment.
PMID:42966492 | DOI:10.1016/j.jbspin.2026.106156