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对2007年至2011年美国痛风就诊情况的评估。

An evaluation of gout visits in the United States for the years 2007 to 2011.

作者信息

Castro Kristen E, Corey Kaitlyn D, Raymond Diana L, Jiroutek Michael R, Holland Melissa A

机构信息

Campbell University College of Pharmacy & Health Sciences, 180 Main Street PO Box 1090, Buies Creek, NC 27506 USA.

出版信息

BMC Rheumatol. 2018 May 30;2:14. doi: 10.1186/s41927-018-0020-0. eCollection 2018.

Abstract

BACKGROUND

This study analyzed visits for and factors associated with gout and gout medication treatment trends for the years 2007-2011 in the United States given the introduction of febuxostat, the first new treatment option for gout in over 40 years, which was introduced to the market in 2009.

METHODS

This study was a retrospective, cross-sectional, observational study of patients age 20 and older seen by providers who participated in the National Ambulatory Medical Care Survey (NAMCS), the National Hospital Ambulatory Medical Care Survey Outpatient Department (NHAMCS-OPD) or Emergency Department (NHAMCS-ED) in the United States. The outcome of interest was visits for gout diagnosis and visits where a gout medication was prescribed.

RESULTS

Approximately 1.2% of visits had a diagnosis of gout. There was a significant increase in the percentage of visits with a diagnosis of gout in years 2009-2011 compared to 2007-2008, which remained after adjusting for covariates of interest. Groups more likely to have a visit with gout included those ≥65 and 45-64 (both as compared to those 20-44), the African-American and 'Other' race groups (as compared to Caucasians) and those on a diuretic. Groups less likely to have a visit with gout included females, Hispanic/Latinos, those with insurance type of 'Other' and Medicaid (both as compared to private insurance) and visits to a hospital emergency setting (as compared to physician's office visits).

CONCLUSION

Although there was a significant increase in visits where gout is diagnosed across study years, the overall percentage of visits with a gout diagnosis is low in the US population. Treatment trends over the study years has remained consistent, with the introduction of febuxostat appearing to have little impact for the study years through 2011.

摘要

背景

鉴于非布司他(febuxostat)于2009年上市,这是40多年来首个用于痛风的新治疗选择,本研究分析了2007 - 2011年美国痛风就诊情况、与痛风相关的因素以及痛风药物治疗趋势。

方法

本研究是一项回顾性、横断面观察性研究,研究对象为年龄20岁及以上、在美国参与国家门诊医疗保健调查(NAMCS)、国家医院门诊医疗保健调查门诊部(NHAMCS - OPD)或急诊科(NHAMCS - ED)的医疗服务提供者所诊治的患者。感兴趣的结果是痛风诊断就诊以及开具痛风药物的就诊情况。

结果

约1.2%的就诊被诊断为痛风。与2007 - 2008年相比,2009 - 2011年痛风诊断就诊的百分比显著增加,在对感兴趣的协变量进行调整后该差异依然存在。更有可能因痛风就诊的群体包括65岁及以上和45 - 64岁人群(与20 - 44岁人群相比)、非裔美国人和“其他”种族群体(与白种人相比)以及使用利尿剂的人群。不太可能因痛风就诊的群体包括女性、西班牙裔/拉丁裔、保险类型为“其他”和医疗补助的人群(与私人保险相比)以及在医院急诊科就诊的人群(与在医生办公室就诊相比)。

结论

尽管在整个研究年份中痛风诊断就诊显著增加,但在美国人群中痛风诊断就诊的总体百分比仍然较低。在整个研究年份中治疗趋势保持一致,截至2011年,非布司他的引入似乎影响不大。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d50/6390619/2b4304cffe48/41927_2018_20_Fig1_HTML.jpg

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