“Association does not equal causation,” he says. “We cannot conclude that vaccines lead to gout flares. There may be confounders.”
“Some limitations to the study include no mention of how gout flares were confirmed,” he Dr. Luk. “Ideally, a joint fluid aspirate showing monosodium urate crystals is the way to be 100% sure it is a true gout flare. So, were gout flares recorded in this study true gout flares? It is unclear, and especially if the data are based on patient reports of a gout flare, it may not be a reliable diagnosis of a flare.”
“Also,” he says, “vaccinations could not be verified in this study, which limits our ability to draw any conclusions here.”
“At this time, it is not routine practice to give gout prophylaxis with vaccines,” he addes. “I would not routinely give anti-inflammatories to patients who have gout and are receiving a vaccine. The risk of GI upset, hypertension, bleeding risk, kidney injury are all side effects of NSAIDS that must be considered.”
“We should still vaccinate based on current guidelines and individualize the decisions based on each patient’s unique, individual situation,” he concludes.
- Yokose C, McCormick N, Chen C, et al. Risk of gout flares after vaccination: A prospective case cross-over study. Ann Rheum Dis. 2019 Jul 31. pii: annrheumdis-2019-215724. [Epub ahead of print]