Neogi T, Chen C, Niu J, et al. Alcohol quantity and type on risk of recurrent gout attacks: An internet-based case-crossover study. (2014) Am J Med, 21 January doi:10.1016/j.amjmed.2013.12.019
This new study resolves weaknesses in earlier research to provide clearer guidance about alcohol and gout: Any type of alcohol, including wine, can trigger gout attacks.
Patients often report that wine has triggered gout attacks, but previous studies had found an association only with beer and liquor. This larger study was sufficiently powered to find an association with wine too.
It also revealed that even moderate intake of alcohol can trigger gout flares.
A prospective, Internet-based case-crossover study, it recruited 724 participants using Google ads for the search term “gout.” The eligible subjects were those who agreed to release their medical records, and whose physicians confirmed the diagnosis according to American College of Rheumatology criteria.
Subjects were queried online about risk factors and medication, first during an attack-free control period, and then during an attack.
Two drinks in a 24-hour period were associated with about a one-third higher risk of recurrent attack. Seven or eight drinks doubled the risk.
The effect of one drink was too small for statistical significance, although there was a trend towards higher risk.
The effects were stronger with high purine intake and diuretic use, and weaker for those taking allopurinol or colchicines.
In earlier studies, beer and liquor were associated with increased risk of incident gout. This may be due to characteristics of the beverage, but the effect may have been confounded by the fact that wine drinkers tend to have healthier lifestyles than beer drinkers, and to eat healthier diets. The case-crossover design minimized some of that bias.