Recombinant Zoster Vaccination Not Associated With Increased Gout Risk Among Older Adults

Older adults receiving a recombinant zoster vaccine (RZV) are not at an increased risk for new-onset gout, according to study results presented at the American College of Rheumatology (ACR) 2023 Annual Meeting in San Diego, CA.

Researchers developed a retrospective, observational study using data from the Centers for Medicare & Medicaid Services (CMS) Chronic Conditions Warehouse database to estimate the risk of new-onset gout following RZV among adults in the United States aged 65 years or older. Those included in the study were enrolled in Medicare Parts A, B, and D and received at least one dose of the two-dose RZV regimen in 2018-2019.

The researchers defined patients with new-onset gout as those diagnosed during the risk period (days 1-30 after vaccination) or control period (days 31-60 after vaccination) either in an inpatient or an outpatient setting, followed by use of allopurinol, colchicine, probenecid, or febuxostat within 3 months, without and earlier gout diagnosis or use of medication in the 365 days before the incident gout case.

Using the CMS Chronic Conditions Warehouse database, researchers identified 1309 patients with gout. Most of these patients were White (87%), male (61%), and 70 to 79 years of age (55%). Although chronic kidney disease, diabetes mellitus, and ischemic heart disease were common comorbidities, most patients had no prior hospitalizations (87%) or emergency department visits (77%).

Of the 1309 patients with gout, 1074 (82%) received two RZV doses, which were distributed evenly between the risk and control windows. A total of 783 instances of gout occurred after dose 1 and 526 incident gout cases occurred after dose 2 (Risk ratio = 1.01 (95% CI, 0.90-1.12). The researchers noted that a temporal scan did not find significant clustering of gout cases during a 60-day follow-up.

“The findings show no statistically significant increased risk of incident gout following receipt of RZV in US adults aged ≥65 years,” the authors concluded.

Reference:
dosReis S, Zhang C, Amill-Rosario, et al. Incident gout after recombinant zoster vaccination in adults aged ≥65 years in the USA. Abstract presented at: American College of Rheumatology 2023 Annual Meeting; November 10-15, 2023; San Diego, CA. Accessed January 15, 2023. https://acrabstracts.org/abstract/incident-gout-after-recombinant-zoster-vaccination-in-adults-aged-%e2%89%a565-years-in-the-usa/