Medical Science Department, Teijin Pharma Limited, Tokyo, Japan.
Pharmaceutical Development Administration Department, Teijin Pharma Limited, Tokyo, Japan.
Mod Rheumatol. 2021 Jan;31(1):261-269. doi: 10.1080/14397595.2020.1784556. Epub 2020 Jul 20.
To assess gout and asymptomatic hyperuricemia in Japan and review treatment conditions.
This retrospective cross-sectional study analyzed the prevalence of hyperuricemia and gout, and characteristics and treatment of patients with those conditions, using Japanese health insurance claims and medical check-up data collected from April 2016 through March 2017.
Among 2,531,383 persons registered in the database, 1.1% (men 1.9%, women <0.1%) were diagnosed with gout and 2.6% (4.1%, 0.4%) with asymptomatic hyperuricemia. Medical check-ups showed 13.4% (19.6%, 1.0%) of patients with hyperuricemia (serum uric acid [sUA] > 7.0 mg/dL). Urate-lowering therapy (ULT) was prescribed for 80.7% of patients identified with gout and 72.4% identified with asymptomatic hyperuricemia. ULT adherence was satisfactory, but most patients were treated with low-dose ULT. Less than half of patients receiving ULT achieved the sUA target (≤6.0 mg/dL). In gout patients, the incidence of gout flare was 47.8% (0.74 flares/person-year).
Although hyperuricemia prevalence is similar in Japan and worldwide, gout is comparatively rare in Japan. Gout and asymptomatic hyperuricemia are often treated with low-dose ULT, and many patients fail to reach target sUA, suggesting that gout management is suboptimal in Japan. Patients would benefit from stricter focus on a treat-to-target approach for gout management.
评估日本的痛风和无症状高尿酸血症，并回顾治疗情况。
本回顾性横断面研究分析了 2016 年 4 月至 2017 年 3 月期间使用日本健康保险索赔和体检数据，评估了高尿酸血症和痛风的患病率、患者特征和治疗情况。
在 2531383 名登记在册的人群中，1.1%（男性 1.9%，女性<0.1%）被诊断为痛风，2.6%（4.1%，0.4%）为无症状高尿酸血症。体检显示 13.4%（19.6%，1.0%）的高尿酸血症患者（血清尿酸[sUA]＞7.0mg/dL）。80.7%的痛风患者和 72.4%的无症状高尿酸血症患者开具了降尿酸治疗（ULT）。ULT 依从性良好，但大多数患者接受低剂量 ULT 治疗。接受 ULT 的患者中，不到一半达到 sUA 目标（≤6.0mg/dL）。在痛风患者中，痛风发作的发生率为 47.8%（0.74 次/人年）。
尽管日本和全球的高尿酸血症患病率相似，但痛风在日本相对较少见。痛风和无症状高尿酸血症通常采用低剂量 ULT 治疗，许多患者未能达到目标 sUA，表明日本痛风管理不理想。患者将受益于更严格地关注痛风管理的达标治疗。
