Age

About

Age is important for gout for several reasons. First, it helps establish an individual's risk of gout. Second, it potentially influences which medications are safest to use for one's gout treatment. And finally, it has a strong impact on kidney function, which in turns effects an individual's risk of gout and hsi or her medication dosing.

Date of Birth

GoutHelper asks for age, not date of birth, because date of birth is considered protected health information (PHI). GoutHelper is not built to deal with PHI and instead keeps things generic and unidentifiable.

Flares

Age is an important consideration when deciding whether or not a patient's symptoms are due to a gout flare or not. It is very rare for men to get gout until after puberty1. Women typically don't get gout until after menopause, as estrogen causes urinary excretion of uric acid and protects them2. There are exceptions for both sexes, such as when an individual has chronic kidney disease (CKD), is on a medication that lowers urinary uric acid excretion, or has rare inborn genetics that predispose him or her to gout.

Medications

When considering what medications are safe for a patient, age needs to be considered for many. For gout, this is most important in the case of non-steroidal anti-inflammatory drugs (NSAIDs). Rates of NSAID-related adverse events go up quite a bit after age 65, and some providers prescribe NSAIDs cautiously or not at all in patients who are 65 or older3. GoutHelper's defaults do not adopt this practice, but it is an important consideration none the less.

Kidney Function

Age is used to calculate kidney function4. Kidney function is very important for safely determining medication doses for several drugs used to treat gout, including the cornerstone treatment ULT. Kidney function also influences colchicine dosing, both for flares and prophylaxis.

References

  1. Singh JA, Gaffo A. Gout epidemiology and comorbidities. Semin Arthritis Rheum. 2020 Jun;50(3S):S11-S16. doi: 10.1016/j.semarthrit.2020.04.008. PMID: 32620196.
  2. Te Kampe, Ritch, et al. "Sex differences in the clinical profile among patients with gout: cross-sectional analyses of an observational study." The Journal of Rheumatology 48.2 (2021): 286-292.
  3. Wongrakpanich, Supakanya, et al. "A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly." Aging and disease 9.1 (2018): 143.
  4. Inker LA, Eneanya ND, Coresh J, Tighiouart H, Wang D, Sang Y, Crews DC, Doria A, Estrella MM, Froissart M, Grams ME, Greene T, Grubb A, Gudnason V, Gutiérrez OM, Kalil R, Karger AB, Mauer M, Navis G, Nelson RG, Poggio ED, Rodby R, Rossing P, Rule AD, Selvin E, Seegmiller JC, Shlipak MG, Torres VE, Yang W, Ballew SH, Couture SJ, Powe NR, Levey AS; Chronic Kidney Disease Epidemiology Collaboration. New Creatinine- and Cystatin C-Based Equations to Estimate GFR without Race. N Engl J Med. 2021 Nov 4;385(19):1737-1749. doi: 10.1056/NEJMoa2102953. Epub 2021 Sep 23. PMID: 34554658; PMCID: PMC8822996.
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