ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1180

Rising Burden Of Gout and Poor Management Of The Disease In The United Kingdom: A Nationwide Population Study

Chang-Fu Kuo1,2, Michael Doherty3, Matthew J. Grainge4 and Weiya Zhang1, 1Academic Rheumatology, School of Clinical Sciences, University of Nottingham, Nottingham, United Kingdom, 2Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taipei, Taiwan, 3Academic Rheumatology, University of Nottingham, Nottingham, United Kingdom, 4Division of Epidemiology and Public Health, School of Community Health Sciences,, University of Nottingham, Nottingham, United Kingdom

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Metabolic and Crystal Arthropathies I

Session Type: Abstract Submissions (ACR)

Background/Purpose: To describe the trends of epidemiology of gout and patterns of urate-lowering treatment in the UK general population from 1997-2012.

Methods: We used the Clinical Practice Research Data-link (CPRD) to estimate the prevalence and incidence of gout and the proportion of gout patients being treated by urate-lowering therapy for each calendar year from 1997 to 2012. To determine trends of prevalence, incidence and management of gout, we used direct standardisation considering the distribution of age, sex and length of data contribution with the population structure in year 2012 as reference. Good adherence for urate-lowering treatment (ULT) was classifed as a proportion of days covers (PDC) of 80% or higher.

Results: Of 4,604,203 eligible individuals in 2012, 115,608 prevalent cases of gout were identified, giving a prevalence of 2.51% (95% CI, 2.50%‒2.52%). Men had a significantly higher prevalence (4.00%; 95% CI, 3.97%‒4.03%) than women (1.05%; 95% CI, 1.04%‒1.06%). There were a total of 4,484,830 person-years of follow-up in this year during which 8401 incident cases of gout were identified (overall incidence 1.87 [95% CI, 1.83‒1.91] per 1000 person-years). Men had a higher incidence (2.74 [95% CI, 2.67‒2.81] per 1000 person-year) than women (1.05 [95% CI, 1.00‒1.09) per 1000 person year). Prevalence and incidence both were significantly higher in 2012 than in 1997, with a 66.7% increase in prevalence and 25.7% increase in incidence. Among prevalent gout patients in 2012, only 44% were under medical attention (with at least one consultation with a gout diagnosis or a prescription for ULT, 31% were prescribed with ULT of which only 47% adhered to treatment. The percentage of patients under medical attention and treated by ULT remained poor from 1997 to 2012 (annual change -0.3% [95%CI -0.5%‒ -0.2%] and 0.1% [95%CI -0.1%‒ -0.3%]), while the adherence increased slightly from 10.7% to 14.6%.

Conclusion: Both prevalence and incidence of gout increased significantly in the UK in the period between 1997 and 2012. Only one-third of gout patients were given ULT and the adherence was poor. The pattern of gout management has not changed despite the rising burden of disease.

Disclosure:

C. F. Kuo,
None;

M. Doherty,
None;

M. J. Grainge,
None;

W. Zhang,
None.

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