Background Gout is the most common inflammatory arthritic disease worldwide. The prevalence varies due to cultural, ethnical and genetic differences in populations, which emphasizes the need for national/regional data on occurrence. There are major insights in the pathogenesis and effective treatments have been available for decades. Despite this several earlier reports state sub-optimal treatment with urate lowering therapy (ULT) of this common and severe disease. Contemporary data on whether this has improved recently are overall few and completely lacking from the Nordic countries.
Objectives In the present study we measured the prevalence of gout in western Sweden and the proportion thereof treated with ULT.
Methods We identified all individuals with one or more ICD-10 diagnosis of gout (M10, M14) in the Western Swedish Health Care Region (WSHCR), Sweden, 2002-01-01 to 2012-12-31 through VEGA, a diagnosis register entailing all visits to physicians in primary and secondary care and hospitalizations in the region with diagnosis according to the Swedish version of ICD-10. WSHCR has 1 600 000 inhabitants, roughly 20% of the population of Sweden and is representative for the country as a whole with regard to demographics and health status. All cases were linked to Statistics Sweden (for death and possible emigration before Dec 2012) and the National Drug Prescription Register (for dispensation of ULT prescriptions during 2012). The point prevalence of gout Dec 2012 was calculated using the number of people aged 20 and above fulfilling our case definitions for gout who were alive and living in WSHCR 2012-12-31 as the numerator and the total population aged 20 and above of WSHCR by 2012–12–31 as the denominator. Dispensation of ULT prescriptions during 2012 were identified for allopurinol, febuxostat and probenecid. The presence of ≥1 dispensation was regarded as ULT treatment in 2012.
Results The prevalence of gout in the Swedish population aged 20 years and above was 1,7% overall and increased with age and male sex (Fig 1), and was more than 3% in males above 50 years of age. Only 43% of the patients received treatment with ULT in 2012, almost exclusively allopurinol (99%). Of these 43%, the majority (59%) received a dose of only 100 mg allopurinol daily.
Conclusions Gout is the most common inflammatory arthritic disease in Sweden with an overall prevalence of 1.7%. Treatment with ULT is still in 2012 insufficient with low a low proportion being treated and those treated receiving low doses.
Disclosure of Interest None declared