Background Gout is the most common form of inflammatory arthritis and is linked with an increased occurrence of several comorbidities that impair quality of life and influence mortality. Population based data from European countries are scarce and the majority of them include limited categories of comorbidities without specifically addressing them to the time of gout diagnosis.
Objectives To examine the occurrence of comorbidities possibly related to gout at the time of first gout diagnosis compared with matched controls from the general population.
Methods Using the regional population-based health care data base in Västra Götaland region in western Sweden, the National prescribed drugs register and the census register, we identified all patients who attended any inpatient, outpatient or primary care clinic in the region and received at least one ICD10-coded diagnosis (M10, M14.0, M14.1) corresponding to gout during 2000 through 2012. In this study, we included only incident cases with first ICD-coded diagnosis of gout between January 1st 2006 and December 31st 2012 (N=14.137, mean age 66.5, 66.3% men). Each case was matched by year of birth, sex and county to 5 general population comparators, alive and without gout at the date of the index patients' first gout diagnosis, identified in the population register (N=65.899). Comorbidities (previously suggested to be related to gout) were defined by at least one visit to a physician in primary or specialized care with corresponding ICD-coded diagnosis or having dispensed a prescription for a medication strongly supporting such diagnosis prior to the index date in cases and controls respectively. The treatment with diuretics and cyclosporine was defined by having dispensed a prescription of these agents within 6 months prior to gout diagnosis. Comorbidities were grouped as “possibly causal”, “metabolic” and “cardiovascular” (CVD) (table).
Results Among “possibly causal” comorbidities, exposure to diuretics (thiazide, loop and potassium-sparing) (48,1%) and renal disease (11,6%) were the overall most frequent and 1,5 to 2,5-fold more common in gout at diagnosis vs controls, whereas diagnosis of psoriasis was not (table).
Among “metabolic”, diagnosis of diabetes or obesity was only modestly more frequent in gout vs controls, whereas hyperlipidemia and hypertension were both very frequent in gout (33,9% and 64,9% respectively) and more common, probably reflecting a high CVD comorbidity in gout (table).
Among “CVD comorbidities”, different aspects of cardiovascular disease were all common (>5%) and highly associated with gout at diagnosis with exception of thromboembolism (table).
Conclusions The majority of gout patients has at least one comorbidity at the time of gout diagnosis and compared to the general population, a higher prevalence of a wide range of comorbidities, such as renal impairment, organ transplantation, cardiovascular diseases and the diseases reflecting the metabolic syndrome.
Disclosure of Interest None declared