JAMA article shows dramatic increase in emergency department visits by gout patients.- Horizon Pharma.

Results from a new study presented in an oral presentation at the Annual European Congress of Rheumatology (EULAR 2018) show a dramatic 27 percent increase in emergency department (ED) visits between 2006 and 2014 for people living with gout in the United States. Horizon Pharma provided research support and funding for this study.

Gout is a chronic, progressive inflammatory form of arthritis that is caused by excess uric acid in the body and needs to be managed aggressively. If uric acid levels in the blood remain elevated, thin rod-like crystals can form and deposit in the joints, which can lead to severe pain, tenderness, stiffness, swelling and joint damage. In addition to the joint damage, urate crystals can also deposit in other organs of the body, and if left unmanaged, gout can lead to significant tissue damage.

The study Emergency Department Visits for Gout: A Dramatic Increase in the Past Decade (abstract OP0185), evaluated data from the Nationwide Emergency Department Sample (NEDS). Dr. Singh and colleagues studied all ED visits with a primary diagnosis of gout from 2006 to 2014 and calculated the prevalence of gout in different age groups using population data from the U.S. Census Bureau. NEDS, which yields national estimates of hospital-based ED visits, is the largest all-payer ED database in the United States, containing information from 31 million ED visits at 945 hospitals in 34 states. The study demonstrated that the total number of ED visits per year among patients with a primary diagnosis of acute gout increased 26.8 percent between 2006 and 2014 – from 168,580 to 213,780. Additional results showed that, over the nine-year period: 1.7 million people visited EDs with a primary diagnosis of acute gout. The prevalence of ED visits with a primary diagnosis of gout increased from 56.5/100,000 population in 2006 to 67/100,000 in 2014 (p<0.001). The largest increase in the prevalence of ED visits occurred among people ages 45 to 64 years – a 28 percent increase from 91/100,000 in 2006 to 116/100,000 in 2014 (p<0.001). Men accounted for 78 percent of the ED visits in both 2006 and 2014.

Comment: Escalating symptoms that reach the threshold of an ED visit suggests that the underlying accumulation of uric acid may not have been adequately addressed.

See: Chronic Disease Approaches Needed to Curb Gout’s Growing Burden