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JAMA has reported the results of an 18-year National Inpatient Sample, a database of US non-federal hospitalizations. They examined the rate of hospitalizations for gout and rheumatoid arthritis (RA) and demonstrated a steady decline in RA, but a growing number of gout hospitalizations.
There were 254,982 hospitalizations for gout and 323,649 hospitalizations for RA between 1993 and 2011.
During this period, the hospitalization rate for RA went down from 13.9 to 4.6 per 100 000 adults (P < .001). At the same time, gout hospitalizatins increased from 4.4 to 8.8 per 100,000 adults. During this same era, the prevalence of RA dropped from 2.5 to 1.3 million affected Americans and the growth of gout (to current 8.3 million) has been fueled by the obesity epidemic.
The authors believe these findings may reflect suboptimal care received by gout patients and its increasing prevalence, while at the same time pointing to the success of earlier diagnosis and more aggressive therapies in RA.