FRI0678 PREVALENCE, PATIENT CHARACTERISTICS, AND TREATMENT OF GOUT AND ASYMPTOMATIC HYPERURICEMIA IN JAPAN: CROSS-SECTIONAL STUDY OF A HEALTH INSURANCE CLAIMS DATABASE
Authors: Ruriko Koto, Akihiro Nakajima, Hideki Horiuchi, Hisashi Yamanaka
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The prevalence of gout is increasing worldwide [1,2], but evidence suggests that current treatment practices do not effectively reduce serum uric acid (sUA) levels in many gout patients [3]. In Japan, urate lowering therapy (ULT) is provided to patients diagnosed with asymptomatic hyperuricemia as well as to those with gout. However, the actual treatment situation for asymptomatic hyperuricemia has not been well-documented. <h3>Objectives</h3> To assess the prevalence and characteristics of gout and asymptomatic hyperuricemia and the current treatment practices for these conditions in Japan. <h3>Methods</h3> This retrospective cross-sectional study assessed disease prevalence, patient characteristics, prescriptions, proportion of patients achieving target sUA, and incidence of gouty arthritis among 2,531,383 individuals in a database, using data from Japanese health insurance claims and medical check-ups from April 2016 to March 2017. <h3>Results</h3> Gout was diagnosed in 1.1% (men 1.9%, women &lt;0.1%) of the study population and asymptomatic hyperuricemia in 2.6% (men 4.1%, women 0.4%). Hyperuricemia (sUA &gt;7.0 mg/dL) was identified in 13.4% (men 19.6%, women 1.0%) of cases in which sUA level was measured at check-up. ULT adherence was satisfactory (median medication possession ratio [MPR] of 69.0% for febuxostat and 78.1% for allopurinol in gout, and 79.5% and 88.5%, respectively, in asymptomatic hyperuricemia), but most patients were receiving low-dose ULT. The sUA target (≤6.0 mg/dL) was achieved by less than half of patients treated with either febuxostat or allopurinol (Table). In gout patients, the incidence proportion of gouty arthritis was 47.8% and the incidence rate was 0.74 flares/person-year. <h3>Conclusion</h3> The prevalence of gout in our study population was low. Japanese physicians often treat gout and asymptomatic hyperuricemia with low-dose ULT, and many patients fail to reach their target sUA, suggesting gout management is suboptimal in Japan. <h3>References</h3> [1] Zhu Y, et al. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum2011;63(10):3136-41. [2] Kuo CF, et al. Global epidemiology of gout: prevalence, incidence and risk factors. Nat Rev Rheumatol2015;11(11):649-62. [3] Roddy E, et al. Concordance of the management of chronic gout in a UK primary-care population with the EULAR gout recommendations. Ann Rheum Dis2007;66(10):1311–5. <h3>Disclosure of Interests</h3> Ruriko Koto Employee of: Teijin Pharma Limited, Akihiro Nakajima Employee of: Teijin Pharma Limited, Hideki Horiuchi Employee of: Teijin Pharma Limited, Hisashi Yamanaka Grant/research support from: AbbVie, Eisai, Bristol-Meyers, Novartis, Behringer, Astellas, Kaken, Nippon-Shinyaku, Pfizer, UCB, Ayumi, Ono, Daiichi-Sankyo, Taisyo-Toyama, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, Torii, YLbio, Speakers bureau: Bristol-Meyers, Astellas, Pfizer, Daiichi-Sankyo, Takeda, Tanabe-Mitsubishi, Chugai, Teijin Pharma, YLbio