Kuo Chang-Fu, Grainge Matthew J, Mallen Christian, Zhang Weiya, Doherty Michael
Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.
Ann Rheum Dis. 2015 Apr;74(4):661-7. doi: 10.1136/annrheumdis-2013-204463. Epub 2014 Jan 15.
To describe trends in the epidemiology of gout and patterns of urate-lowering treatment (ULT) in the UK general population from 1997 to 2012.
We used the Clinical Practice Research Datalink to estimate the prevalence and incidence of gout for each calendar year from 1997 to 2012. We also investigated the pattern of gout management for both prevalent and incident gout patients.
In 2012, the prevalence of gout was 2.49% (95% CI 2.48% to 2.51%) and the incidence was 1.77 (95% CI 1.73 to 1.81) per 1000 person-years. Prevalence and incidence both were significantly higher in 2012 than in 1997, with a 63.9% increase in prevalence and 29.6% increase in incidence over this period. Regions with highest prevalence and incidence were the North East and Wales. Among prevalent gout patients in 2012, only 48.48% (95% CI 48.08% to 48.89%) were being consulted specifically for gout or treated with ULT and of these 37.63% (95% CI 37.28% to 38.99%) received ULT. In addition, only 18.6% (95% CI 17.6% to 19.6%) of incident gout patients received ULT within 6 months and 27.3% (95% CI 26.1% to 28.5%) within 12 months of diagnosis. The management of prevalent and incident gout patients remained essentially the same during the study period, although the percentage of adherent patients improved from 28.28% (95% CI 27.33% to 29.26%) in 1997 to 39.66% (95% CI 39.11% to 40.22%) in 2012.
In recent years, both the prevalence and incidence of gout have increased significantly in the UK. Suboptimal use of ULT has not changed between 1997 and 2012. Patient adherence has improved during the study period, but it remains poor.
描述1997年至2012年英国普通人群中痛风的流行病学趋势及降尿酸治疗（ULT）模式。
我们利用临床实践研究数据链来估算1997年至2012年各日历年痛风的患病率和发病率。我们还调查了痛风患者（包括现患和新发病例）的痛风管理模式。
2012年，痛风患病率为2.49%（95%置信区间2.48%至2.51%），发病率为每1000人年1.77例（95%置信区间1.73至1.81）。2012年的患病率和发病率均显著高于1997年，在此期间患病率增加了63.9%，发病率增加了29.6%。患病率和发病率最高的地区是东北部和威尔士。在2012年的痛风现患患者中，仅48.48%（95%置信区间48.08%至48.89%）因痛风接受专门咨询或接受ULT治疗，其中37.63%（95%置信区间37.28%至38.99%）接受了ULT治疗。此外，仅18.6%（95%置信区间17.6%至19.6%）的痛风新发病例在诊断后6个月内接受了ULT治疗，27.3%（95%置信区间26.1%至28.5%）在12个月内接受了ULT治疗。在研究期间，痛风现患和新发病例的管理基本保持不变，尽管依从性患者的比例从1997年的28.28%（95%置信区间27.33%至29.26%）提高到了2012年的39.66%（95%置信区间39.11%至40.22%）。
近年来，英国痛风的患病率和发病率均显著增加。1997年至2012年期间，ULT的使用未达最佳状态且无变化。在研究期间患者的依从性有所改善，但仍较差。
