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

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.

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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.

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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.

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Source: self

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