Worldwide, Gout Cases and Years of Disability Rising

By Linda Carroll

August 07, 2020

(Reuters Health) - The prevalence of gout and the years lived with disability due to the condition are on the rise worldwide, a new study finds.

An analysis of nearly three decades of data shows that gout cases had risen by more than 7% and there had been an equal increase in the number of years lived with the disease, Australian researchers reported in Arthritis and Rheumatology.

"The increasing trend of gout burden is most likely to continue as the global aging population is on the rise," said coauthor Emma Smith, of the Institute of Bone and Joint Research at the Faculty of Medicine and Health at the University of Sydney.

"After the disease onset, there is no turning back as you will not recover from the disease," Smith said in an email. "You won't die from the disease either. You will be living in a situation with suboptimal quality of life due to the disability caused by the disease, particularly during gout flare."

With other, limited studies suggesting gout was on the rise, Smith and her colleagues decided to see if this was a worldwide trend and turned to data from the Global Burden of Diseases, Injuries and Risk Factors Study.

They found there were approximately 41.2 million prevalent cases of gout in 2017, a 7.2% increase over 1990. Worldwide, there were 7.4 million incident cases in 2017, an increase of 5.5% over 1990 numbers.

The researchers calculated that worldwide in 2017, disease sufferers had experienced nearly 1.3 million years living with disability tied to gout, an increase of 7.2% over 1990.

Global point prevalence estimates per 100,000 were found to be higher among men than women in 2017 and higher in older age groups. The number of incident gout cases were highest in the 60-64 year old age group.

The highest point prevalence estimate of gout per 100,000 in 2017 was in Australasia at 1,206 per 100,000. In high-income North America it was 984.3 per 100,000 and in Southern Latin America it was 834.4 per 100,000. In contrast, Central Latin America had a point prevalence rate of 258.9 per 100,000, tropical Latin America a rate of 301.2 per 100,000 and Andean Latin America a rate of 308.5 per 100,000.

When the researchers focused in on specific nations, they found that New Zealand had the highest rate per 100,000, at 1,394, followed by Australia at 1,171.4 and the U.S. at 996.0. Countries with the lowest rates per 100,000 included Panama at 231.4, Columbia at 234. 6 and Guatemala at 239.4.

The new data are concerning, said Dr. Eric Ruderman, a professor in rheumatology at Northwestern University Feinberg School of Medicine in Chicago.

"While gout is not a life-threatening illness, it causes a significant amount of morbidity," Dr. Ruderman said in an email. "The pain and the impact on function can be substantial."

"The next step is to understand the reasons for this increase," Dr. Ruderman said. "Is it greater awareness and earlier recognition? This might be a good thing, as it could lead to earlier treatment and better outcomes. On the other hand, if it is related to risk factors like diet and obesity, particularly in developed countries, then this could be seen as a call to action to address these critical issues."

SOURCE: Arthritis and Rheumatology, online August 4, 2020.