Gout rates soaring in UK, but treatment remains poor

UK rates of gout have soared since the late1990s, with one in every 40 people now affected – the highest level in Europe – but treatment remains as poor now as it was then, reveals research published in the Annals of the Rheumatic Diseases.

The researchers used a large database of 12 million records and investigated treatment for those who already had gout and those who were newly diagnosed (within six to 12 months) to see how well their condition was being managed.

Among more than 4.5 million eligible people on the database in 2012, almost 116,000 already had gout (ie 2.5% of people). Men were more likely to have been diagnosed with gout than women and highest numbers of cases were in Wales and the North East of England. New cases were highest in people aged 80–84 years.

Between 1997 and 2012, the prevalence of gout rose by 64%, increasing by around 4% every year.

Rates were around four times higher in men across the entire period. The number of new cases rose by 30% during this time, increasing by around 1.5% each year. Men were around three times as likely to be diagnosed with the condition as women across the entire period.

The patterns of both prevalence and incidence varied widely across the UK, with prevalence highest in the North East of England and Wales, and lowest in Scotland and Northern Ireland. New diagnoses were lowest in the East of England and Northern Ireland and again highest in Wales and the North East of England.

Only a third of people with gout were being treated with urate lowering drugs. In 2012, fewer than one in five patients was prescribed these drugs within six months of their diagnosis, and only around one in four was on this treatment a year after diagnosis, a pattern that remained more or less unchanged since 1997, despite the publication of guidelines on optimal management of the condition.

Patients got better at taking their drugs, with around four out of 10 doing so in 2012, compared with 28% in 1997, but these figures are still not a cause for celebration, say the authors.