Background/Purpose The prevalence of gout has been studied in several Western countries by various methods to approach gout diagnosis, and has been estimated to vary from 0.9 to 3.9 %. The prevalence of gout remained unknown in France. The aims of our study was to design a tool that would allow a confident diagnosis of gout in an epidemiological setting and to assess the current prevalence of gout in France.

Methods This was a two phase study. In phase one, we designed a questionnaire to detect gout that would be suitable for telephone interviews by non-physicians. A 62-item questionnaire covering clinical features, co-morbidities and treatment of gout was administered by phone, by non physicians unaware of the patient diagnoses in a case control study. 102 people with crystal-proven gout and 142 controls who had other types of arthritis with no urate crystal in their synovial fluid were included. Logistic regression analysis and classification and regression trees (CARTs) were used to select items discriminating cases from controls. In phase two, a random sample of adults resident in metropolitan France (including Corsica) was derived from the national telephone (fixed and mobile) directory, using the next birthday method in cases of multiple users.  The telephone questionnaire was administered by non-physicians to subjects who acknowledged present or past non traumatic acute pain in a peripheral joint.  The target size for the interview survey was 10,000 participants. Statistical analysis took into account several factors (area, size of the urban centre, sex, age, occupation, known distribution of fixed or mobile users).

Results

In phase one, two logistic regression models (sensitivity 88.0% and 87.5%; specificity 93.0% and 89.8%, respectively) and one CART model (sensitivity 81.4%; specificity 93.7%) revealed 11 informative items that allowed correct classification of 90.0%, 88.8% and 88.5% of patients respectively. In the second phase the response rate varied between 34 % (fixed phone sample) and 38 % (mobile sample). 10,026 participants were interviewed between March and June 2013. 373 declared having suffered from acute, non traumatic joint pain, of whom a diagnosis of gout was made in 84 to 102 subjects, according to the algorithm used. This led to an estimated prevalence of gout of 0.9% ( 95% CI: 0.8, 1.1) in the general population, with no significant geographic variation. Prevalence was greater in men and increased with age. Interestingly prevalence estimate on self declaration only gave a much higher prevalence estimate (3.7%)

Conclusion Gout prevalence in the adult population of metropolitan France in 2013 was estimated to be 0.9%. Studies using self declaration might grossly  overestimate the prevalence of gout.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/prevalence-of-gout-in-the-adult-population-of-france-in-2013/