Ted Mikuls, MD, MSPH, Stokes-Shackleford professor of rheumatology, vice chair for research, internal medicine at the University of Nebraska, discusses his study comparing rates of lower extremity amputations in US veterans with and without gout, using data from the national Veterans Health Administration.
The study, published recently in JAMA Network Open, showed that lower extremity amputations appear to be performed more frequently in patients with gout, explained lead author Ted Mikuls, MD, MSPH, Stokes-Shackleford professor of rheumatology, vice chair for research, internal medicine at the University of Nebraska.
What are the most important takeaways from your study?
I was interested in this study mainly because, in the clinic, I've seen this. I take care a lot of gout patients and, over the years, I've seen several of these patients who've come in with amputations and found me asking the question, "does that occur more frequently in patients with gout?" You wouldn't naturally think that would occur. For those with gout, are some of those preventable? The real take home from this study is that lower extremity amputations do seem to be performed more frequently in patients who suffer from gout. This is independent of other risk factors that are more common in gout patients, such as peripheral vascular disease and diabetes.
Like other studies involving older veterans, 99% of the participants were male. Are these findings limited to male patients or can the results be generalized to women as well?
The short answer is we don't know. We don't know whether the findings are generalizable. I have every reason to think they probably are. I say that because this population—although a male, older, veteran population—in many ways looks a lot like patients in other gout studies. Gout is a disease that predominantly affects older men with comorbidities, so I think likely when and if this gets tested in other populations, you would see that it was generalizable. We haven't done specific breakdowns on men versus women with the finding, but the findings were independent of sex in the study. So it will be interesting to see whether others who look at maybe other large populations see similar results.
Transcript edited for clarity.