Cardioprotective Aspirin Is Associated with Elevated Risk for Gout

Jonathan S. Coblyn, MD

But concomitant use of urate-lowering agents might minimize the effect.

Aspirin's dual effects on urate handling are well known: High-dose aspirin is uricosuric and lowers serum uric acid, whereas low-dose aspirin (≤2 g daily) blocks urate secretion and raises serum uric acid. Anecdotally, low-dose aspirin use has been associated with gout attacks. In this observational study, investigators examined the association between low-dose aspirin use and recurrent gout attacks in 724 patients (median age, 54; 78% men; 18% with renal insufficiency) with gout who were enrolled in a gout study and followed for 1 year. Participants provided data on exposure to risk factors, including aspirin use, during the 2 days prior to gout attacks (hazard periods) and during 2-day control periods every 3 months.

Compared with no aspirin use, aspirin use at usual cardiovascular doses (i.e., ≤325 mg daily or ≤81 mg daily) on 2 consecutive days during hazard periods was associated with roughly twofold higher risk for recurrent gout. Concomitant use of allopurinol neutralized these effects.

Citation(s):

Zhang Y et al. Low-dose aspirin use and recurrent gout attacks. Ann Rheum Dis 2014 Feb; 73:385.