Russell Mark D, Yates Mark, Bechman Katie, Rutherford Andrew I, Subesinghe Sujith, Lanyon Peter, Galloway James B
From the Centre for Rheumatic Diseases, King's College London, London; Nottingham University Hospitals UK National Health Service (NHS) Trust, Nottingham; Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham, Nottingham, UK.
M.D. Russell, MB BChir, MA, MRCP, Centre for Rheumatic Diseases, King's College London; M. Yates, MBChB, BSc, MRCP, Centre for Rheumatic Diseases, King's College London; K. Bechman, MBChB, BSc, MRCP, Centre for Rheumatic Diseases, King's College London; A.I. Rutherford, MBBS, MSc, MRCP, Centre for Rheumatic Diseases, King's College London; S. Subesinghe, BSc, MBBS, MSc, MRCP, Centre for Rheumatic Diseases, King's College London; P. Lanyon, DM, MRCP, Nottingham University Hospitals NHS Trust, and Division of Rheumatology, Orthopaedics and Dermatology, University of Nottingham; J.B. Galloway, MBChB, MSc, MRCP, PhD, Centre for Rheumatic Diseases, King's College London.
J Rheumatol. 2020 Apr;47(4):619-623. doi: 10.3899/jrheum.190257. Epub 2019 Sep 15.
To describe trends in acute hospital admissions due to gout in England, with rheumatoid arthritis (RA) as a comparator, alongside prescribing trends for common gout medications.
An ecological study was performed using UK National Health Service (NHS) Digital Hospital Episode Statistics data to calculate the incidence of unplanned admissions with primary diagnoses of gout or RA in adults in England between April 2006 and March 2017. NHS Digital Community Prescription data for allopurinol, febuxostat, and colchicine were considered over a similar period.
The incidence of unplanned gout admissions increased by 58.4% over the study period, from 7.9 admissions per 100,000 population in 2006/07 to 12.5 admissions per 100,000 population in 2016/17 (p < 0.0001). Gout admissions increased as a proportion of all hospital admissions, and accounted for 349,768 bed-days cumulatively. Unplanned RA admissions halved over the study period, from 8.6 admissions per 100,000 population in 2006/07 to 4.3 admissions per 100,000 population in 2016/17 (p < 0.0001). Community prescriptions dispensed for allopurinol and colchicine have increased by 71.4% and 165.6%, respectively, since 2006 (p < 0.0001). Febuxostat prescriptions have increased 20-fold since 2010 (p < 0.0001), when prescription data became available.
Acute gout admissions in England increased between 2006 and 2017, accompanied by increasing prescription of gout therapies. Acute admissions due to RA halved over the same time period. These data call for aggressive target-driven therapy for this highly treatable disease.
描述以类风湿性关节炎（RA）作为对照，英格兰因痛风导致的急性住院趋势，以及常见痛风药物的处方趋势。
采用生态研究方法，利用英国国家医疗服务体系（NHS）数字医院病历统计数据，计算2006年4月至2017年3月期间英格兰成年人原发性痛风或RA的非计划住院发病率。同时考虑了同期NHS数字社区中别嘌醇、非布司他和秋水仙碱的处方数据。
在研究期间，非计划痛风住院发病率增加了58.4%，从2006/07年度的每10万人7.9例增加到2016/17年度的每10万人12.5例（p<0.0001）。痛风住院占所有住院的比例增加，累计占用349,768个床位日。在研究期间，非计划RA住院减少了一半，从2006/07年度的每10万人8.6例降至2016/17年度的每10万人4.3例（p<0.0001）。自2006年以来，别嘌醇和秋水仙碱的社区配药处方分别增加了71.4%和165.6%（p<0.0001）。自2010年有处方数据以来，非布司他处方增加了20倍（p<0.0001）。
2006年至2017年期间，英格兰急性痛风住院人数增加，同时痛风治疗药物的处方量也在增加。同期因RA导致的急性住院人数减少了一半。这些数据表明，对于这种高度可治疗的疾病，需要积极采取目标导向治疗。
