Real-world treatment of gout and asymptomatic hyperuricemia: A cross-sectional study of Japanese health insurance claims data

Abstract

Objectives

To assess gout and asymptomatic hyperuricemia in Japan and review treatment conditions.

Methods

This retrospective cross-sectional study analyzed the prevalence of hyperuricemia and gout, and characteristics and treatment of patients with those conditions, using Japanese health insurance claims and medical check-up data collected from April 2016 through March 2017.

Results

Among 2,531,383 persons registered in the database, 1.1% (men 1.9%, women <0.1%) were diagnosed with gout and 2.6% (4.1%, 0.4%) with asymptomatic hyperuricemia. Medical check-ups showed 13.4% (19.6%, 1.0%) of patients with hyperuricemia (serum uric acid [sUA] > 7.0 mg/dL). Urate-lowering therapy (ULT) was prescribed for 80.7% of patients identified with gout and 72.4% identified with asymptomatic hyperuricemia. ULT adherence was satisfactory, but most patients were treated with low-dose ULT. Less than half of patients receiving ULT achieved the sUA target (≤6.0 mg/dL). In gout patients, the incidence of gout flare was 47.8% (0.74 flares/person-year).

Conclusions

Although hyperuricemia prevalence is similar in Japan and worldwide, gout is comparatively rare in Japan. Gout and asymptomatic hyperuricemia are often treated with low-dose ULT, and many patients fail to reach target sUA, suggesting that gout management is suboptimal in Japan. Patients would benefit from stricter focus on a treat-to-target approach for gout management.

Keywords:

• Epidemiology
• gout
• hyperuricemia
• urate-lowering therapy
• uric acid

Acknowledgments

Support for study planning and information on data handling for the database were provided by Gen Terashima, JMDC Inc. Review of the statistical analysis plan, clinical study report, and manuscript was provided by Hirotaka Mano, Pharmaceutical Development Administration Department, Teijin Pharma Limited. Medical writing support was provided by EDIT, Inc. (Tokyo, Japan) and was funded by Teijin Pharma Limited.

Conflict of interest

RK, AN and HH are employees of Teijin Pharma Limited, and HY reports grants and personal fees from Teijin Pharma Limited.