ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 90

Insufficient Evidence For An Increase In Prevalence and Incidence Of Gout: A Systematic Review and Meta-Regression Analysis

José M.A. Wijnands1, Wolfgang Viechtbauer2, Kristof Thevissen3, Ilja C.W. Arts4, Pieter C. Dagnelie4, Coen D.A. Stehouwer5, Sjef van der Linden3 and Annelies Boonen3, 1Department of Internal Medicine, Division of Rheumatology, Maastricht University, Maastricht, Netherlands, 2Department of Psychiatry and Psychology, Maastricht University, Maastricht, Netherlands, 3Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center, Maastricht, Netherlands, 4Department of Epidemiology, Maastricht University, Maastricht, Netherlands, 5Department of Internal Medicine, Maastricht University Medical Center, Maastricht, Netherlands

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords:

Session Information

Title: Epidemiology and Health Services I

Session Type: Abstract Submissions (ACR)

Background/Purpose: Estimates on the prevalence and incidence of gout in the general population vary widely and an increase is commonly reported. However, studies on the occurrence of gout have not been reviewed and appraised systematically. The aims of this study were: 1) to estimate the pooled prevalence and the incidence of gout in the general population; 2) to explore which factors contribute to the variation in estimated prevalence and incidence.

Methods: Pubmed, Embase and Web of Science were systematically searched for primary studies on the prevalence and incidence of gout in the general population. Two reviewers independently extracted data on prevalence and incidence as well as sources of clinical heterogeneity, methodological heterogeneity, and variation in outcome reporting. Prevalence rates were pooled using a random-effects model and were adjusted for a series of clinical and methodological study characteristics in a meta-regression analysis using the mixed-effects model.

Results: Of 1466 articles screened, 77 articles were included, of which 71 reported the prevalence and 12 the incidence of gout. The pooled prevalence based on a random effects model was 0.8% (95% CI 0.6; 1.0) with a high level of heterogeneity (I² =99.9%). Results from a mixed-effects meta-regression model indicated that gender (p<0.001), continent (p<0.001), consistency in data collection (p=0.003), and case definition (p=0.001) were significantly associated with gout prevalence and jointly accounted for 77.2% of the heterogeneity. Start of data collection was not associated with the prevalence. The incidence in the total population ranged from 0.06 to 2.68 per 1000 person-years and an increase in incidence was only seen in two studies.

Conclusion: The large variation in the prevalence data on gout in the general population is explained not only by well-known factors such as gender and continent on which the study was performed, but also by the case definition of gout. There was insufficient evidence for an increase in prevalence or incidence of gout in recent years.

Disclosure:

J. M. A. Wijnands,
None;

W. Viechtbauer,
None;

K. Thevissen,
None;

I. C. W. Arts,
None;

P. C. Dagnelie,
None;

C. D. A. Stehouwer,
None;

S. van der Linden,
None;

A. Boonen,
None.

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