Most US Gout Sufferers Not Taking Urate-Lowering Drugs
Gout is uncontrolled in the majority of individuals with the condition, data show.
ORLANDO, Fla. — Most individuals in the United States who have been diagnosed with gout are not currently taking adequate medication to lower uric acid levels, according to study findings presented at the National Kidney Foundation's 2017 Spring Clinical Meetings.
In addition, regardless of chronic kidney disease (CKD) stage, the majority of gout sufferers do not have the condition under control.
To estimate the prevalence of CKD, serum uric acid levels, and treatment with xanthine oxidase inhibitors (XOI, allopurinol or febuxostat) among gout patients, Jean J. Lim, MA, of Tufts University School of Medicine in Boston, and colleagues analyzed data from 15,868 individuals aged 20 years or older who participated in the National Health and Nutrition Examination Surveys (NHANES) 2007–2012. Of these respondents, 715 had been told by a doctor they had gout. These respondents represented an estimated total of 7.7 million individuals with gout in the United States (US prevalence of 3.7%).
Of the estimated gout population, 5.7 million individuals (74%) had normal to stage 2 CKD, 1.1 million (15%) had stage 3a CKD, and 0.8 million (11%) had stage 3b-5 CKD, Lim and colleagues reported in a poster presentation.
Most of the estimated gout population had uncontrolled gout—defined as the presence of a gout diagnosis and a serum uric acid level of 6 mg/dL or higher—regardless of CKD stage. Results showed that among the estimated gout population with normal to stage 2 CKD, uncontrolled gout was presented in 44% of those who were taking an XOI and 68% of those who were not taking an XOI. In the estimated gout population with stage 3a CKD, uncontrolled gout was present in 36% of those who were taking an XOI and 80% of those not taking an XOI. In the estimated gout population with stage 3b–5 CKD, uncontrolled gout was present in 57% of those taking an XOI and 83% of those not taking an XOI.
In the estimated gout population, current use of an XOI (mostly allopurinol) was found in 22% of individuals with normal to stage 2 CKD, 42% of those with stage 3a CKD, and 44% of those with stage 3b–5 CKD.
“The majority of non-institutionalized US adults who self-report that they have been diagnosed with gout have uncontrolled gout regardless of CKD stage, with the highest proportion of uncontrolled gout among those patients who have Stage 3b-5 CKD,” the investigators wrote.
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Lim JJ, Fu AC, Reasner D, Taylor DCA. Prevalence of CKD and uncontrolled gout among US adults: Results from NHANES 2007–2012. Poster presented at the National Kidney Foundation's 2017 Spring Clinical Meetings in Orlando, Florida. Poster 243.