Rising Prevalence and Burden of Disease
Over the last 30 years, there was a 100% increase in prevalence of gout, which is out of proportion to the 42% increase in the world population or the rise in life expectancy. The Global Burden of Disease Study in 2017 estimated that approximately 41.2 million adults are living with gout worldwide, more than double the number of people living with rheumatoid arthritis.[1,2] The prevalence of gout in the USA alone is 9.2 million (3.9% of USA adults). The incidence and prevalence of gout are higher in racial/ethnic minorities and in older adults.
Gout is associated with a 17% higher all-cause mortality risk than those without gout, with cardiovascular disease (CVD) being the most common cause of death. In addition, renal disease was associated with 1.78 times higher risk of cause-specific mortality in those with gout compared with those without. Although a decrease in excess risk of premature mortality compared with the general population has been observed in rheumatoid arthritis over time, this trend has not been observed in gout, with similar excess risk of mortality for patients diagnosed with gout in 1999–2006 as compared to 2007–2014.
Gout contributes to tremendous healthcare costs. A 2015 meta-analysis estimated all-cause annual direct costs among employed patients ranging from $4733 to $9353 per capita. Costs are higher for older adults ($16 925) and patients with treatment refractory gout ($18 362). Emergency department visits for gout increased from 2006 to 2012 by 14%, and healthcare charges increased by 80% in the USA. Whereas hospitalization rates for rheumatoid arthritis patients declined by 67% from 1993 to 2011, hospitalization rates doubled for patients with gout. Furthermore, patients with gout incur high indirect costs related to the work impairment and productivity loss.
Curr Opin Rheumatol. 2022;34(2):118-124. © 2022 Lippincott Williams & Wilkins