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

Abstract 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 associat...

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Main Authors: Charlotte Proudman, Susan E. Lester, David A. Gonzalez-Chica, Tiffany K. Gill, Nicola Dalbeth, Catherine L. Hill
Format: Article
Language:English
Published: BMC 2019-05-01
Series:Arthritis Research & Therapy
Subjects:
Online Access:http://link.springer.com/article/10.1186/s13075-019-1918-7
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spelling doaj-9a1a571a663547a8bc78b7a211a4e2dd2020-11-25T02:52:33ZengBMCArthritis Research & Therapy1478-63622019-05-012111810.1186/s13075-019-1918-7Gout, flares, and allopurinol use: a population-based studyCharlotte Proudman0Susan E. Lester1David A. Gonzalez-Chica2Tiffany K. Gill3Nicola Dalbeth4Catherine L. Hill5Adelaide Medical School, Faculty of Health and Medical Sciences, The University of AdelaideRheumatology Unit, The Queen Elizabeth HospitalDiscipline of General Practice, Faculty of Health and Medical Sciences, The University of AdelaideAdelaide Medical School, Faculty of Health and Medical Sciences, The University of AdelaideDepartment of Medicine, University of AucklandRheumatology Unit, The Queen Elizabeth HospitalAbstract 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.http://link.springer.com/article/10.1186/s13075-019-1918-7GoutGout flaresAllopurinolSelf-reportedPrevalencePopulation study
collection DOAJ
language English
format Article
sources DOAJ
author Charlotte Proudman
Susan E. Lester
David A. Gonzalez-Chica
Tiffany K. Gill
Nicola Dalbeth
Catherine L. Hill
spellingShingle Charlotte Proudman
Susan E. Lester
David A. Gonzalez-Chica
Tiffany K. Gill
Nicola Dalbeth
Catherine L. Hill
Gout, flares, and allopurinol use: a population-based study
Arthritis Research & Therapy
Gout
Gout flares
Allopurinol
Self-reported
Prevalence
Population study
author_facet Charlotte Proudman
Susan E. Lester
David A. Gonzalez-Chica
Tiffany K. Gill
Nicola Dalbeth
Catherine L. Hill
author_sort Charlotte Proudman
title Gout, flares, and allopurinol use: a population-based study
title_short Gout, flares, and allopurinol use: a population-based study
title_full Gout, flares, and allopurinol use: a population-based study
title_fullStr Gout, flares, and allopurinol use: a population-based study
title_full_unstemmed Gout, flares, and allopurinol use: a population-based study
title_sort gout, flares, and allopurinol use: a population-based study
publisher BMC
series Arthritis Research & Therapy
issn 1478-6362
publishDate 2019-05-01
description Abstract 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.
topic Gout
Gout flares
Allopurinol
Self-reported
Prevalence
Population study
url http://link.springer.com/article/10.1186/s13075-019-1918-7
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