Weight Loss After Receiving Anti-Obesity Medications and Gout Among Individuals With Overweight and Obese: A Population-Based Cohort Study.

OBJECTIVE: Weight loss is conditionally recommended for gout management; however, its impact on incident gout and recurrent gout flares among individuals who were overweight and obese remains unknown. We investigate the relationship between weight loss rate following treatment with anti-obesity medications and the risk of incident gout and recurrent gout flares among individuals who were overweight or obese. METHODS: Using data from the Health Improvement Network, we selected individuals aged 18 and older who were overweight or obese and started anti-obesity medication. We emulated a target trial to examine the association of different weight loss rates, slow (2%-5%), moderate (5%-10%), or fast (≥10%), within the first year of treatment with incident gout and recurrent gout flares during a 5 year follow-up period. RESULTS: Among 131,000 participants without gout being treated with orlistat, the 5-year risk of incident gout was 1.6% for those with weight gain or stability, compared with 1.5%, 1.3%, and 1.2% for those with slow, moderate, and fast weight loss, respectively. Compared with the group with weight gain or stability, the hazard ratios were 0.91 (95% confidence interval [CI] 0.81-1.01), 0.82 (95% CI 0.72-0.92), and 0.73 (95% CI 0.62-0.86) for those with a slow, moderate, and fast rate of weight loss, respectively. Similar results were observed for the recurrent gout flares among 3,847 individuals with overweight or obese with gout treated with orlistat. CONCLUSION: A higher rate of weight loss after receiving treatment with orlistat within 1 year was associated with lower risks of incident gout and lower rates of recurrent gout flares among overweight or obese people.