Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database View Full Text


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Article Info

DATE

2020-10-15

AUTHORS

Shuichi Ito, Tomoko Torii, Akihiro Nakajima, Takeshi Iijima, Hiroshi Murano, Hideki Horiuchi, Hisashi Yamanaka, Masataka Honda

ABSTRACT

BackgroundAlthough gout is rare in children, chronic sustained hyperuricemia can lead to monosodium urate deposits progressing to gout, just as in adults. This study assessed prevalence and characteristics of gout and asymptomatic hyperuricemia, and incidence of gouty arthritis in the pediatric population, using data from Japanese health insurance claims. The diagnosis and treatment of pediatric gout and hyperuricemia were analyzed, and specific characteristics of those patients were assessed. Since Japanese guidelines recommend treatment with uric acid lowering drugs for asymptomatic hyperuricemia as well as for gout, these data were also used to investigate the real-world use of uric acid lowering drugs in a pediatric population.MethodsThis cross-sectional study was based on a 2016–2017 Japanese health insurance claims database, one of the largest epidemiology claims databases available in Japan, which included 356,790 males and 339,487 females 0–18 years of age. Outcomes were measured for prevalence, patient characteristics, treatment with uric acid lowering drugs for gout and asymptomatic hyperuricemia, and prevalence and incidence of gouty arthritis. Because uric acid can be elevated by some forms of chemotherapy, data from patients under treatment for malignancies were excluded from consideration.ResultsTotal prevalence of gout and asymptomatic hyperuricemia in 0–18 year-olds was 0.040% (276/696,277 patients), with gout prevalence at 0.007% (48/696,277) and asymptomatic hyperuricemia at 0.033% (228/696,277). Prevalence of gout and asymptomatic hyperuricemia was highest in adolescent males, at 0.135% (176/130,823). The most common comorbidities for gout and asymptomatic hyperuricemia were metabolic syndrome at 42.8% (118/276) and kidney disease at 34.8% (96/276). Of the patients diagnosed with gout or asymptomatic hyperuricemia, 35.1% (97/276) were treated with uric acid lowering drugs. Gouty arthritis developed in 43.8% (21/48) of gout patients during the study, at an incidence of 0.65 flares/person-year.ConclusionsEven the pediatric population could be affected by asymptomatic hyperuricemia, gout, and gouty arthritis, and uric acid lowering drugs are being used in this population even though those drugs have not been approved for pediatric indications. Such off-label use may indicate a potential need for therapeutic agents in this population.Trial registrationUMIN000036029. More... »

PAGES

481

Identifiers

URI

http://scigraph.springernature.com/pub.10.1186/s12887-020-02379-0

DOI

http://dx.doi.org/10.1186/s12887-020-02379-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1131721512

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/33059648


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37 Japan
38 Japanese guidelines
39 Japanese health insurance
40 Japanese health insurance claims
41 Japanese health insurance database
42 MethodsThis cross-sectional study
43 acid
44 adolescent males
45 adults
46 age
47 agents
48 arthritis
49 asymptomatic hyperuricemia
50 characteristics
51 chemotherapy
52 children
53 chronic
54 claims
55 claims database
56 common comorbidities
57 comorbidities
58 consideration
59 cross-sectional study
60 data
61 database
62 deposits
63 diagnosis
64 disease
65 drugs
66 females 0
67 flares
68 form
69 form of chemotherapy
70 gout
71 gout patients
72 gout prevalence
73 gouty arthritis
74 guidelines
75 health insurance
76 health insurance claims
77 hyperuricemia
78 incidence
79 indications
80 insurance
81 insurance claims
82 insurance database
83 kidney disease
84 label use
85 males
86 malignancy
87 metabolic syndrome
88 monosodium urate deposits
89 need
90 outcomes
91 patient characteristics
92 patients
93 pediatric indications
94 pediatric population
95 population
96 potential need
97 prevalence
98 prevalence of gout
99 real-world use
100 specific characteristics
101 study
102 syndrome
103 therapeutic agents
104 treatment
105 urate deposits
106 uric acid
107 use
108 years
109 years of age
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