Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose: Hyperuricemia and gout are associated with major cardiovascular and metabolic comorbidities. Recently published data on comorbidities and gout epidemiology in the US have been drawn from the 2007-2008 National Health and Nutrition Examination Survey (NHANES),1,2 thus underscoring the need for current information. Here we present data from the subscription-based 2010-2012 National Health and Wellness Survey (NHWS; Kantar Health).
Methods: The NHWS is an Internet-based survey of adults aged ≥18 years providing self-reported information on treatment, healthcare attitudes and behaviors, disease and demographic characteristics (N=71,157). Mean values were weighted/projected to match gender, age, and race in accordance with current US Census Bureau data. NHWS members were recruited from the Lightspeed Research panel, whose members were recruited through e-mail and Web site advertisements, and other panels. All participants provided informed consent and were nominally compensated.
Results: The majority of respondents were men (77%) and mean time since gout diagnosis was 12.3 years. Close to half of these patients (42%) were age 65 years or older. A large proportion of gout patients were unaware of their serum uric acid (sUA) levels (71%); 17% reported sUA below 6 mg/dL and 13% reported sUA >6 mg/dL. Gout was classified as mild in 52%, moderate in 33% and severe in 15%. Table 1 shows key comorbidities and healthcare utilization for the NHWS cohorts with and without gout; Table 2 displays trends over time. Respondents with gout had significantly higher utilization of inpatient, outpatient, and emergency room services and were hospitalized more often than respondents without gout. The overall prevalence of gout in the 2012 NHWS was 2.4%, slightly higher than that reported by the NHWS in 2011 (2%) and 2010 (1.7%) but lower than that reported using NHANES 2007-2008 (3.9%).
Conclusion: Current data from the NHWS demonstrated a higher incidence of comorbidities and gout when compared to NHANES III. This difference could be attributed to mode of survey administration (Internet vs home-based) along with the growing epidemic of obesity. Trends from 3 years showed modest reductions in healthcare utilization over time that are promising and have implications for gout-related healthcare cost.
References:
1. Zhu et al. Am J Med. 2012.
2. Singh J. Curr Rheumatol Rep. 2013.
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Table 1. Characteristics of Gout vs No Gout Populations |
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Total Sample 2012 |
US Adults No Gout |
US Adults w/ Gout |
US Adults w/ Gout and Rx |
US Adults w/ Gout, No Rx |
|
NHWS sample |
N=71,157 |
n=69,161 |
n=1996 |
n=1347 |
n=649 |
|
Total projected to US population |
230.3M |
224.7M |
5.6M |
3.7M |
1.9M |
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|
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% Men |
48 |
48 |
77 |
79 |
72 |
|
Mean age (years) |
46.4 |
46.1 |
60.4 |
61.6 |
58 |
|
Pain |
34 |
34 |
53* |
51 |
56 |
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Self-Reported Comorbidities (% of sample) |
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Hypertension |
26 |
25 |
66* |
69 |
60** |
|
Hyper |
25 |
24 |
56* |
59 |
51** |
|
Diabetes |
10 |
10 |
30* |
33 |
24** |
|
Arthritis other than gout |
20 |
20 |
52* |
54 |
47** |
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Healthcare Resource Utilization (% of sample with 1 or more visits) |
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Visited GP in past 6 months |
47 |
47 |
69* |
72 |
63** |
|
Visited HCP in past 6 months |
72 |
72 |
90* |
93 |
84** |
|
Visited ER in past 6 months |
12 |
12 |
17* |
18 |
15 |
|
Hospitalized in past 6 months |
7 |
6 |
11* |
13 |
8** |
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Mean Healthcare Resource Utilization |
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Mean # visits in past 6 months |
3.4 |
3.3 |
5.6* |
6.0 |
4.7** |
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*Denotes statistical significance vs the sample with no gout. **Denotes statistical significance vs gout with Rx. |
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Table 2. Medication Usage and Treatment Patterns Over Time |
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2010 |
2011 |
2012 |
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% With Gout on Rx |
68% |
66% |
66% |
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Allopurinol |
NA |
NA |
75% |
|
Febuxostat |
NA |
NA |
7% |
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Patient Attitudes |
|
|
|
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% with gout who consult HCP when ill |
38% |
36% |
35% |
|
23% |
20% |
19% |
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Resource Utilization |
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|
|
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% visited GP in past 6 months |
NA |
67% |
69% |
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% visited any HCP in past 6 months |
93% |
90% |
90% |
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Mean # visits in past 6 months |
6.3 |
6 |
5.6 |
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% visited ER in past 6 months |
22% |
19% |
17% |
|
% hospitalized in past 6 months |
16% |
13% |
11% |
Disclosure:
J. A. Singh,
Takeda, Savient,
2,
Savient, Takeda, Ardea, Regeneron, Allergan, URL Pharmaceuticals and Novartis.,
5;
K. Annunziata,
Kantar Health ,
3;
P. Khanna,
Takeda,
9.
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