The rising prevalence and incidence of gout in British Columbia, Canada: Population-based trends from 2000 to 2012

Abstract

Objectives Gout is increasingly recognized as the most common form of inflammatory arthritis worldwide; however, no Canadian data on the disease burden of gout are available. We estimated the prevalence, incidence, prescription patterns, and comorbidity burden of gout in an entire Canadian province (British Columbia [BC]) over the last decade. Methods We utilized PopulationData BC, a province-wide database, to estimate temporal trends in the prevalence and incidence of gout from 2000-2012, as well as according to age category. Annual estimates were age-sex-standardized using 2012 as the reference. We also examined annual trends in prescription patterns of common gout medications and assessed the comorbidity burden among gout patients in 2012. Results The 2012 prevalence of gout was 3.8% among the overall population, and the incidence rate was 2.9 per 1,000 person-years. Both gout prevalence and incidence increased substantially over the study period. This burden additionally increased according to age category, affecting over 8% of those ages 60-69 years in 2012. Approximately 22% of gout patients received a prescription for urate-lowering therapy (ULT), which remained stable over the study period, while colchicine and oral glucocorticoid use both increased modestly. By 2012, 72%, 52%, and 18% of prevalent gout patients had been diagnosed with hypertension, hyperlipidemia, and diabetes, respectively. Conclusions The burden of gout in BC, Canada, is substantial, and both the prevalence and incidence have increased over the past decade, while prescription of ULT remains low. These data support the need to improve gout prevention and care.

Contemporary Prevalence of Gout and Hyperuricemia in the United States and Decadal Trends: The National Health and Nutrition Examination Survey, 2007–2016

“…The frequency of ULT use by gout patients remained largely unchanged between 2007 and 2014 in the US, with approximately one‐third of gout patients reporting ULT use. The ULT use prevalence observed in our study was largely in accordance with previous estimates from other countries, including Canada (~22%) , the UK (30–38%) , western Sweden (42%) , and New Zealand (41%) . Actual prevalence rates depend on the rate of ULT initiation as well as continuation of prescribed treatment.…”

“…The nationally representative New Zealand Health Survey showed that the overall prevalence of self‐reported physician‐diagnosed gout among those ages 15 years or older nearly doubled from 1.6% in 2011–2012 to 2.9% in 2015–2016 ( P < 0.001), with a concomitant increase in the prevalence of obesity over the same period . Similarly, a Canadian study using administrative health claims showed a trend of increasing prevalence from 2.4% in 2000 to 3.8% in 2012 in the overall population . Moreover, a UK general practice population–based study also showed an increasing trend, from 2.03% in 2007 to 2.49% in 2012 .…”

Trends in Gout and Rheumatoid Arthritis Hospitalizations in Canada From 2000 to 2011

“…A recent study found a similarly increasing number of primary gout hospitalizations in New Zealand and England between 1999 and 2009, although hospitalization rates were not reported . Moreover, our inpatient trends are consistent with the increasing incidence of gout in Canada over the same study period . However, this magnitude of increase appears substantially smaller than that of gout hospitalizations, as above.…”

Population Impact Attributable to Modifiable Risk Factors for Hyperuricemia

“…Moreover, the Tokelau Island migrant study showed that the incidence of gout between 1968 and 1982 was 9.0× higher in migrant men living in urban New Zealand than in nonmigrant men living in their isolated atoll homeland, with consistent serum urate level changes among men <55 years old . Finally, contemporary epidemiologic data from Canada, Europe, New Zealand, and China all suggest that gout incidence and prevalence are increasing , which correlates with obesity trends .…”

“…Moreover, the Tokelau Island migrant study showed that the incidence of gout between 1968 and 1982 was 9.0× higher in migrant men living in urban New Zealand than in nonmigrant men living in their isolated atoll homeland, with consistent serum urate level changes among men <55 years old (14). Finally, contemporary epidemiologic data from Canada, Europe, New Zealand, and China all suggest that gout incidence and prevalence are increasing (3,(15)(16)(17), which correlates with obesity trends (2,7). This historical background and epidemiologic data are at odds with a recent study that showed ≤0.3% of serum urate variance in the US to be explained by dietary components, particularly when compared with the variance explained by common genome-wide genes (i.e., genome-wide association study heritability estimate of 23.9%) (18).…”