Despite readily available treatment, gout remains under-treated, finds study

Australia: Gout continues to be a prevalent and poorly managed disease, despite readily available treatment, concludes a recent study published in the journal Arthritis Research & Therapy. A quarter of participants with gout reported frequent flares that were associated with reduced physical health-related quality of life (HRQoL).

Current allopurinol use was reported by only 51% of participants with frequent gout flares, suggesting undertreated disease and suboptimal use of urate-lowering therapy (ULT).

Gout is the most common inflammatory arthritis. The reported prevalence of gout is highly variable across the world, ranging from 0.1% to approximately 10%, with prevalence estimates greater than 1% in most developed countries. Flares were frequently reported by people with gout in the community. Gout flares were associated with reduced physical HRQoL.

There is limited data on the prevalence and impact of gout flares as they are often self-managed. Catherine L. Hill, The University of Adelaide, Adelaide, South Australia, and colleagues conducted the study to determine the prevalence of self-reported gout and gout flares, the use of ULT, and the association of gout flares with HRQoL in a large community sample.

The South Australian Health Omnibus Survey is an annual, face-to-face population-based survey. Data collected in the 2017 survey included self-reported medically diagnosed gout, allopurinol use (first-line ULT in Australia), and gout attacks (flares) in the last 12 months, in addition to sociodemographic variables and health-related quality of life (HRQoL, SF-12). Data were weighted to the Australian Bureau of Statistics 2016 census data to reflect the South Australian population. Participants, 25 years and over (n = 2778) were included in the analysis.

Key findings of the study include:

• The prevalence of gout was 6.5%.


• Amongst participants with gout, 37.1% (95%CI 29.6, 45.3) reported currently using allopurinol, while 23.2% (95%CI 16.9, 21.0) reported prior use (38% discontinuation rate).


• Frequent flares (≥ 2 in the last year) were reported by 25% of participants with gout and were more likely with younger age, higher body mass index, and current allopurinol use.


• The frequency of gout flares was associated with a lower physical HRQoL. Current allopurinol use was reported by 51% of participants with frequent gout flares.

"Determining covariate associations with flares and ineffective allopurinol use may identify means of improving treatment and reducing flares," concluded the authors.

For a detailed study follow the link: https://doi.org/10.1186/s13075-019-1918-7