The rising prevalence and incidence of gout in British Columbia, Canada: Population-based trends from 2000 to 2012

Abstract

Objectives: Gout is increasingly recognized as the most common form of inflammatory arthritis worldwide; however, no Canadian data on the disease burden of gout are available. We estimated the prevalence, incidence, prescription patterns, and comorbidity burden of gout in an entire Canadian province [British Columbia (BC)] over the last decade.

Methods: We utilized PopulationData BC, a province-wide database, to estimate temporal trends in the prevalence and incidence of gout from 2000 to 2012, as well as according to age category. Annual estimates were age-sex-standardized using 2012 as the reference. We also examined annual trends in prescription patterns of common gout medications and assessed the comorbidity burden among gout patients in 2012.

Results: The 2012 prevalence of gout was 3.8% among the overall population, and the incidence rate was 2.9 per 1000 person-years. Both gout prevalence and incidence increased substantially over the study period. This burden additionally increased according to age category, affecting over 8% of those ages 60-69 years in 2012. Approximately 22% of gout patients received a prescription for urate-lowering therapy (ULT), which remained stable over the study period, while colchicine and oral glucocorticoid use both increased modestly. By 2012, 72%, 52%, and 18% of prevalent gout patients had been diagnosed with hypertension, hyperlipidemia, and diabetes, respectively.

Conclusions: The burden of gout in BC, Canada, is substantial, and both the prevalence and incidence have increased over the past decade, while prescription of ULT remains low. These data support the need to improve gout prevention and care.

Keywords: Canada; Epidemiology; Gout; Incidence; Prescription patterns; Prevalence; Urate-lowering therapy.

Figure 1

Trends in prevalence (A) and incidence (B) of gout in 2012 according to age category. Green: overall, blue: male, red: female.

Figure 2

Age-sex-standardized trends in prevalence (A) and incidence (B) of gout from 2000-2012. Green: overall, blue: male, red: female.

Figure 3

Proportion of prevalent gout cases who received treatment with ULT (green), traditional NSAIDs (orange), colchicine (blue), and glucocorticoids (purple) over the study period.

Figure 4

Comorbidity burden among prevalent and incident gout cases in 2012. Comorbidities were assessed anytime during the study period for prevalent cases and within 10 years prior to the index date for incident cases.