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Open Access Commentary

Can racial disparities in optimal gout treatment be reduced? evidence from a randomized trial

Jasvinder A Singh

Author Affiliations

Medicine Service, Birmingham VA Medical Center and Department of Medicine, University of Alabama, Birmingham, AL, USA

Center for Surgical Medical Acute care Research and Transitions (C-SMART), Birmingham VA Medical Center, Birmingham, AL, USA

Division of Epidemiology, School of Public Health, University of Alabama, Birmingham, AL, USA

Department of Orthopedic Surgery, Mayo Clinic School of Medicine, Rochester, MN, USA

University of Alabama, Faculty Office Tower 805B, 510 20th Street S, Birmingham, AL 35294, USA

BMC Medicine 2012, 10:15  doi:10.1186/1741-7015-10-15

Published: 9 February 2012

Abstract

There is a disproportionate burden of gout in African-Americans in the U.S. due to a higher disease prevalence and lower likelihood of receiving urate-lowering therapy (ULT), compared to Caucasians. There is an absence of strong data as to whether the response to ULT differs by race/ethnicity. BMC Musculoskeletal Disorders recently published a secondary analyses of the CONFIRMS trial, a large randomized controlled, double-blind trial of 2,269 gout patients. The authors reported that the likelihood of achieving the primary study efficacy end-point of achieving serum urate < 6 mg/dl was similar between African-Americans and Caucasians, for all three treatment arms (Febuxostat 40 mg and 80 mg and allopurinol 300/200 mg). More importantly, rates were similar in subgroups of patients with mild or moderate renal insufficiency. Adverse event rates were similar, as were the rates of gout flares. These findings constitute a convincing evidence to pursue aggressive ULT in gout patients, regardless of race/ethnicity. This approach will likely help to narrow the documented racial disparities in gout care.

Please see related article: http://www.biomedcentral.com/1471-2474/13/15 webcite

Keywords:
Gout; Disparity; Race; treatment; Febuxostat; Allopurinol; randomized; African-American