Epidemiology and management of gout in Taiwan: a nationwide population study

Chang-Fu Kuo, Matthew J Grainge, Lai-Chu See, Kuang-Hui Yu, Shue-Fen Luo, Weiya Zhang, Michael Doherty

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.