Epidemiology of gout in Hong Kong: a population-based study from 2006 to 2016
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RESEARCH ARTICLE
Open Access
Epidemiology of gout in Hong Kong: a population-based study from 2006 to 2016 Tsoi Man Fung1, Chung Man Ho2, Cheung Bernard Man Yung1,3,4, Lau Chak Sing1 and Cheung Tommy Tsang1,5*
Abstract Objective: To determine the incidence and prevalence of gout in the general population and the utilisation of urate-lowering therapy (ULT) among patients with gout in Hong Kong. Methods: A total of 2,741,862 subjects who attended any outpatient clinics or accident and emergency department (with or without hospitalisation) in 2005 and did not die before 2006 were identified from the Clinical Data Analysis and Reporting System (CDARS) of the Hospital Authority in Hong Kong. All subjects were followed until the end of 2016 or death. Demographics, diagnosis of gout, serum urate levels, and ULT prescriptions were retrieved from CDARS. Gout was defined by the diagnosis codes in CDARS. The serum urate levels achieved after prescribing ULT were the means of all serum urate levels measured 6 months after prescriptions. Results were analysed by R version 3.3.3 with package ‘prevalence’ version 0.4.0. Results: The crude incidence of gout increased from 113.05/100,000 person-years (PY) in 2006 to 211.62/100,000 PY in 2016. The crude prevalence of gout increased from 1.56% in 2006 to 2.92% in 2016. Only 25.55% of patients with gout were prescribed ULT in 2016. 35.8% of patients treated with ULT were able to achieve the target serum urate level of < 6 mg/dL. Conclusions: Population ageing as well as other risk factors contributed to an increase in the incidence and prevalence of gout in Hong Kong. In 2016, the crude prevalence of gout in Hong Kong was comparable to that in many western countries. However, only one in four patients with gout in Hong Kong was prescribed ULT. Keywords: Gout, Hong Kong, Epidemiology, Urate-lowering therapy
Introduction Gout is the most common inflammatory arthritis caused by deposition of monosodium urate crystals in peripheral joints. Although the prevalence of gout was estimated to be 0.08% globally [1], it has increased significantly over the last decade, especially in developed countries and Oceanic populations. The estimated prevalence of gout in the United States (US), UK, and European countries is * Correspondence: [email protected] 1 Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China 5 Department of Medicine, Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, China Full list of author information is available at the end of the article
2–3% [2, 3]. Asian countries and regions except Taiwan are considered to have a lower prevalence of gout due to differences in ethnicity and lifestyle [4, 5]. The American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) recommend urate-lowering therapy (ULT) in all patients with recurrent flare, tophi, chronic kidney disease, and urolithiasis. In particular, EULAR also recommends initiation of ULT close to the time of first diagnosis in patients with earlyonset go
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