Epidemiology and management of gout in Taiwan: a nationwide population study
Research article
1 Division of Rheumatology, Orthopaedics and Dermatology, School of Medicine, University of Nottingham, Nottingham, UK
2 Division of Rheumatology, Allergy and Immunology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
3 Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK
4 Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan
5 Biostatistics Core Laboratory, Molecular Medicine Research Centre, Chang Gung University, Taoyuan, Taiwan
Arthritis Research Therapy 2015, 17:13Â
doi:10.1186/s13075-015-0522-8
Published: 23 January 2015
Abstract (provisional)
IntroductionGout is the most common inflammatory arthritis worldwide and is the only
chronic arthritis that potentially can be `cured?. However, data exploring gout incidence,
prevalence and management, assessed at multiple time points in the same population,
are sparse, particularly in Asian populations. This study aimed to describe trends
in the epidemiology of gout in the general population of Taiwan.MethodsThe National
Health Insurance Research Database was used to identify gout patients and to estimate
the prevalence and incidence of gout for each year from 2005 to 2010. The pattern
of gout management was also examined.ResultsOf 23,371,362 beneficiaries in 2010 there
were 1,458,569 prevalent and 56,595 incident cases of gout, giving a prevalence of
6.24% (95% CI, 6.23% to 6.25%) and an incidence of 2.74 (95% CI, 2.72 to 2.76) per
1,000 person-years. The annual percentage change (APC) of the standardised prevalence
was -0.7 (95% CI, -1.7 to 0.3; P?=?0.14), suggesting that the prevalence of gout was
essentially the same throughout the study. However, The APC of incidence was -13.4
(95% CI, -16.1 to -10.6) between 2005 and 2007 and -2.1 (95% CI, -10.4 to 7.1) between
2007 and 2010. Regions with the highest prevalence and incidence were eastern coast
counties and offshore islets, where indigenous people cluster. Among prevalent gout
patients in 2010, only 22.93% (95% CI, 22.87% to 23.00%) were prescribed urate-lowering
treatment (ULT), which remained unchanged between 2005 and 2010 with an APC of 0.0
(95% CI, -3.8 to 4.0). Uricosuric agents were more commonly prescribed than xanthine
oxidase inhibitors in Taiwan.ConclusionsIn Taiwan 1 in 16 people have gout. While
the incidence has decreased recently, the prevalence remains unchanged. Management
of gout in Taiwan is poor, with only 1 in 5 affected people being treated with ULT.