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Despite Gout Numbers and Flares, Allopurinol is Underutilized

A population-based survey from South Australia shows that gout flares are common in the community and have a significant effect on health-related quality of life (HRQoL), yet there is significant undertreatment of gout, even in those on current allopurinol.

The South Australia Health Omnibus Survey is an annual, face-to-face adult population-based survey that collected information on self-reported medically diagnosed gout, allopurinol use and gout attacks (flares) in the prior 12 months.

Overall the findings showed:

  • the prevalence of gout in the population was 6.5%
  • 37.1% of gout patients were on current allopurinol and 23.2% reported prior use
  • frequent flares (≥ 2/year) were reported by 25% of gout
    • were more likely with: younger age, higher BMI, and current allopurinol use (p < 0.05)
    • in those with frequent gout flares, 51% were on current allopurinol therapy
  • gout flares were associated with a lower physical HRQoL (p = 0.012). 

Despite the prevalence, flares rates and HRQoL effects seen with gout, only 37% were on allopurinol (51% in those with frequent attacks).

Undertreated disease and suboptimal use of urate lowering therapy continue to plaque gout management in the populace.

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Disclosures
The author has no conflicts of interest to disclose related to this subject