Gout, flares, and allopurinol use: a population-based study.


Journal

Arthritis research & therapy
ISSN: 1478-6362
Titre abrégé: Arthritis Res Ther
Pays: England
ID NLM: 101154438

Informations de publication

Date de publication:
31 05 2019
Historique:
received: 29 11 2018
accepted: 15 05 2019
entrez: 2 6 2019
pubmed: 4 6 2019
medline: 28 5 2020
Statut: epublish

Résumé

There is a paucity of community-based data regarding the prevalence and impact of gout flares as these may often be self-managed. The aim of this study was to determine the prevalence of self-reported gout and gout flares, the use of urate-lowering therapy (ULT), and the association of gout flares with health-related quality of life (HRQoL) in a large community sample. Covariate associations with flare frequency and allopurinol use were also examined. 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. The prevalence of gout was 6.5% (95%CI 5.5, 7.5). 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 (p < 0.05). The frequency of gout flares was associated with a lower physical HRQoL (p = 0.012). Current allopurinol use was reported by 51% of participants with frequent gout flares. Flares were frequently reported by people with gout in the community. Gout flares were associated with reduced physical HRQoL. Almost one half of people with frequent gout flares were not receiving allopurinol, and current allopurinol use was associated with frequent gout flares, suggesting undertreated disease and suboptimal use of ULT. Determining covariate associations with flares and ineffective allopurinol use may identify means of improving treatment and reducing flares.

Sections du résumé

BACKGROUND
There is a paucity of community-based data regarding the prevalence and impact of gout flares as these may often be self-managed. The aim of this study was to determine the prevalence of self-reported gout and gout flares, the use of urate-lowering therapy (ULT), and the association of gout flares with health-related quality of life (HRQoL) in a large community sample. Covariate associations with flare frequency and allopurinol use were also examined.
METHODS
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.
RESULTS
The prevalence of gout was 6.5% (95%CI 5.5, 7.5). 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 (p < 0.05). The frequency of gout flares was associated with a lower physical HRQoL (p = 0.012). Current allopurinol use was reported by 51% of participants with frequent gout flares.
CONCLUSION
Flares were frequently reported by people with gout in the community. Gout flares were associated with reduced physical HRQoL. Almost one half of people with frequent gout flares were not receiving allopurinol, and current allopurinol use was associated with frequent gout flares, suggesting undertreated disease and suboptimal use of ULT. Determining covariate associations with flares and ineffective allopurinol use may identify means of improving treatment and reducing flares.

Identifiants

pubmed: 31151457
doi: 10.1186/s13075-019-1918-7
pii: 10.1186/s13075-019-1918-7
pmc: PMC6544947
doi:

Substances chimiques

Gout Suppressants 0
Allopurinol 63CZ7GJN5I

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

132

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Auteurs

Charlotte Proudman (C)

Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia.

Susan E Lester (SE)

Rheumatology Unit, The Queen Elizabeth Hospital, Woodville Road, Woodville South, 5011, South Australia.
Discipline of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia.

David A Gonzalez-Chica (DA)

Discipline of General Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia.

Tiffany K Gill (TK)

Adelaide Medical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia.

Nicola Dalbeth (N)

Department of Medicine, University of Auckland, Auckland, New Zealand.

Catherine L Hill (CL)

Rheumatology Unit, The Queen Elizabeth Hospital, Woodville Road, Woodville South, 5011, South Australia. Catherine.Hill@sa.gov.au.
Discipline of Medicine, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, South Australia. Catherine.Hill@sa.gov.au.

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Classifications MeSH