Arthritis Care & Research · IF 3.7 · August 10, 2026 · LoE III
Osteoporotic fracture, diagnostic activity, and treatment in patients with gout
Emily E. Holladay, Jingyi Zhang, Fenglong Xie, Angelo Gaffo, A. Woods, Shanette Daigle, Brian LaMoreaux, Jeffrey R. Curtis — University of Advancing Technology
This retrospective cohort study used a US rheumatology registry linked to Medicare claims to compare gout patients with osteoarthritis (OA) and soft tissue rheumatism (STR) patients regarding osteoporosis screening, treatment, and fracture rates. Gout patients had higher rates of nonvertebral osteoporotic fracture than OA (incidence rate ratio 1.4, 95% CI 1.1-1.8) and STR (IRR 2.0, 95% CI 1.3-3.1) patients, despite having more risk factors like chronic kidney disease and higher glucocorticoid exposure, yet they were less likely to undergo DXA screening or receive bone-protective medications.
AI summary · from the full text · reviewed by Pukhraj Gaheer, Medical Student, Queen's University before publishing
Why it mattersIt highlights that gout patients, who are frequently exposed to glucocorticoids and have comorbid CKD, are being under-screened and undertreated for osteoporosis despite bearing a higher fracture burden, a gap relevant to any clinician managing bone health in this population.
Conclusion strengthConfirms prior evidence
This identifies a risk factor rather than testing a treatment, so it cannot support a change in what we do.
Presenting this at rounds? Start here
- ?Should routine gout management protocols incorporate mandatory DXA screening and fracture-risk assessment given the elevated fracture rates observed in this cohort?
- ?How should glucocorticoid dosing and duration be balanced against osteoporosis risk when treating recurrent gout flares in patients with comorbid CKD?