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Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination
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  • Published on:
    Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination
    • Tianxiang Fan, MD 1. Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China, 510280
    • Other Contributors:
      • Yang Li, MD
      • Muhui Zeng, MD
      • Shibo Chen, MD
      • Peihua Cao, PhD
      • Zhaohua Zhu, PhD

    We read with great interest the article titled ‘Colchicine prophylaxis is associated with fewer gout flares after COVID-19 vaccination’ by Lu et al.1. The authors found that COVID-19 vaccination was associated with increased odds of gout flare and was negatively associated with colchicine prophylaxis. However, we would like to draw attention to some concerns.

    First, it is problematic to present multiple (over eight covariates) adjusted effect estimates from a single model in Table 3. The findings present in Table 3 may mix direct and total effect of each variable and make interpretation difficult2. Specifically, in current study, the authors aimed to assess the total effect of COVID-19 vaccination (the primary exposure) on the odds of gout flare while adjusting for other potential confounders3. Thus, the odds ratios for other covariates (e.g. colchicine prophylaxis treatment) are likely to reflect the direct effect of each covariate rather than total effect, and such a direct effect may be biased due to potential selection bias 4. For example, the odds ratio of sex increased dramatically from 0.82 in univariate analysis to 4.33 in model 2 analysis, which was biologically controversial.

    Second, the calculation of odds ratios for vaccination and its subgroups in Table 3 seems questionable. Using the same reference group (no vaccination), the odds ratio of gout flares for any COVID-19 vaccines was 4.57 (p< 0.001), for subgroup of Sinovac Life vaccine was 2....

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    Conflict of Interest:
    None declared.