Trends in Gout Hospitalization in Sweden

Dehlin, Mats; Jacobsson, Lennart

doi:10.3899/jrheum.170381

Cited by 9 publications

(4 citation statements)

References 4 publications

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“…In Sweden, the Skåne Healthcare Register provides nationwide data for rheumatologists to study gout. Therefore, the rheumatologists could analyze the data with different dimensions, including by region and population [ 54 , 58 - 62 ]. In Taiwan, the researchers focused on the comorbidities caused by gout [ 63 - 68 ].…”

Section: Discussionmentioning

confidence: 99%

Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction

He¹,

Mok²,

Sin³

et al. 2023

JMIR Public Health Surveill

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Background Gout is a common and debilitating condition that is associated with significant morbidity and mortality. Despite advances in medical treatment, the global burden of gout continues to increase, particularly in high–sociodemographic index (SDI) regions. Objective To address the aforementioned issue, we used age-period-cohort (APC) modeling to analyze global trends in gout incidence and prevalence from 1990 to 2019. Methods Data were extracted from the Global Burden of Disease Study 2019 to assess all-age prevalence and age-standardized prevalence rates, as well as years lived with disability rates, for 204 countries and territories. APC effects were also examined in relation to gout prevalence. Future burden prediction was carried out using the Nordpred APC prediction of future incidence cases and the Bayesian APC model. Results The global gout incidence has increased by 63.44% over the past 2 decades, with a corresponding increase of 51.12% in global years lived with disability. The sex ratio remained consistent at 3:1 (male to female), but the global gout incidence increased in both sexes over time. Notably, the prevalence and incidence of gout were the highest in high-SDI regions (95% uncertainty interval 14.19-20.62), with a growth rate of 94.3%. Gout prevalence increases steadily with age, and the prevalence increases rapidly in high-SDI quantiles for the period effect. Finally, the cohort effect showed that gout prevalence increases steadily, with the risk of morbidity increasing in younger birth cohorts. The prediction model suggests that the gout incidence rate will continue to increase globally. Conclusions Our study provides important insights into the global burden of gout and highlights the need for effective management and prophylaxis of this condition. The APC model used in our analysis provides a novel approach to understanding the complex trends in gout prevalence and incidence, and our findings can inform the development of targeted interventions to address this growing health issue.

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Section: Discussionmentioning

confidence: 99%

Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction

He¹,

Mok²,

Sin³

et al. 2023

JMIR Public Health Surveill

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“… 2 25–27 Moreover, healthcare costs for patients with gout might be substantially underestimated, as gout is often unrecognised as the underlying disease and, consequently, not accurately registered. 25 In our study, several patients had prior hospital contacts that retrospectively appeared to be unrecognised gout flares or tophi, erroneously diagnosed, and treated as ulcers, septic arthritis or erysipelas. This emphasises the importance of improved gout recognition and management to avoid unnecessary hospitalisations and optimise healthcare utilisation.…”

Section: Discussionmentioning

confidence: 82%

Optimising gout treatment: insights from a nurse-led cohort study

Rasmussen,

Larsen,

Christensen

et al. 2024

RMD Open

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ObjectivesCurrently, gout management, particularly urate-lowering therapy (ULT), is often suboptimal. Nurses successfully manage various diseases including gout. As gout prevalence is rising, and rheumatologists and general practitioners face shortages, a new approach is imperative. This real-life prospective cohort study evaluated the effectiveness of nurse-led care employing a treat-to-target strategy for gout management over a 2-year period.MethodsAll consecutively confirmed gout patients were included. The nurse-led clinic provided a structured treatment plan with consultations, patient leaflets, telephone contacts and laboratory monitoring. After a year of nurse-led care, patients transitioned to continued care in general practice. Follow-up data were complete through registries. The primary outcome was achieving target p-urate levels (<0.36 mmol/L) at 2 years after diagnosis. Secondary outcomes included treatment continuation and achievement of target p-urate levels in specific subgroups. The results were compared with patients diagnosed in the same clinic but followed up in ‘usual care’.ResultsIn the nurse-led group (n=114), 83% achieved target p-urate levels and ULT was continued by 98%. This trend persisted across various patient subgroups. Only 44% of patients in usual care achieved target p-urate and with insufficient doses of allopurinol . Nurse-led care involved an average of two visits and three telephone contacts over 336 days. The 2-year mortality rate was 15%.ConclusionsNurse-led gout care, employing a targeted approach, was associated with a very high uptake of and adherence to ULT. The encouraging results were not achieved in usual care although a direct comparison might be influenced by selection bias.

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“…As many as 2.5% of adults in the United Kingdom 1 and 4.0% in the USA 2 are affected and admissions to hospital of patients with gout have increased considerably in Europe and North America. [3][4][5] Inadequately treated gouty arthritis leads to structural joint damage, physical disability and chronic impairment of health-related quality of life (HRQOL). 6 In addition, gout is frequently associated with comorbidities 7 such as chronic kidney disease (CKD), obesity, diabetes mellitus, hypertension and cardiovascular disease, and with increased mortality.…”

Section: Introductionmentioning

confidence: 99%

Changing Paradigms in the Management of Gout

Nuki

Riches

2020

Journal of the Royal College of Physicians of Edinburgh

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The incidence and prevalence of gout have increased, as have comorbid obesity, diabetes mellitus, hypertension, chronic kidney and cardiovascular disease. Gout is now the commonest type of inflammatory arthritis despite availability of safe, effective and potentially ‘curative’ urate-lowering drugs. Modern imaging studies show that gout is a chronic inflammatory crystal deposition disorder even at the first acute attack and they illuminate the need to eliminate urate crystals by continuing reduction of the serum urate below its solubility threshold. Clinical outcomes, adherence to therapy and quality of gout care in primary care and hospital practice can be greatly improved by better use of allopurinol and flare prophylaxis, greater patient engagement, education and follow-up, and by nurse-led models of care that employ a ‘treat-to-target’ principle (SUA< 360 or 300μmol/l). Advances in understanding the physiology and genetic control of urate transport in the kidney and gut have led to novel, more selective uricosuric drugs, and basic research on mediators of urate crystal-induced inflammation has pointed to alternative therapeutic targets for treating and preventing gout flares. Current guidelines for the management of gout and indications for the use of some more recently introduced drugs; febuxostat, lesinurad, pegloticase and interleukin-1 antagonists are also briefly reviewed.

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Trends in Gout Hospitalization in Sweden

Cited by 9 publications

References 4 publications

Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction

Global, Regional, and National Prevalence of Gout From 1990 to 2019: Age-Period-Cohort Analysis With Future Burden Prediction

Optimising gout treatment: insights from a nurse-led cohort study

Changing Paradigms in the Management of Gout

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