Cargando…

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

BACKGROUND: Although 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 po...

Descripción completa

Detalles Bibliográficos
Autores principales: Ito, Shuichi, Torii, Tomoko, Nakajima, Akihiro, Iijima, Takeshi, Murano, Hiroshi, Horiuchi, Hideki, Yamanaka, Hisashi, Honda, Masataka
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559194/
https://www.ncbi.nlm.nih.gov/pubmed/33059648
http://dx.doi.org/10.1186/s12887-020-02379-0
_version_ 1783594805804138496
author Ito, Shuichi
Torii, Tomoko
Nakajima, Akihiro
Iijima, Takeshi
Murano, Hiroshi
Horiuchi, Hideki
Yamanaka, Hisashi
Honda, Masataka
author_facet Ito, Shuichi
Torii, Tomoko
Nakajima, Akihiro
Iijima, Takeshi
Murano, Hiroshi
Horiuchi, Hideki
Yamanaka, Hisashi
Honda, Masataka
author_sort Ito, Shuichi
collection PubMed
description BACKGROUND: Although 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. METHODS: This 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. RESULTS: Total 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. CONCLUSIONS: Even 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 REGISTRATION: UMIN000036029.
format Online
Article
Text
id pubmed-7559194
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-75591942020-10-15 Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database Ito, Shuichi Torii, Tomoko Nakajima, Akihiro Iijima, Takeshi Murano, Hiroshi Horiuchi, Hideki Yamanaka, Hisashi Honda, Masataka BMC Pediatr Research Article BACKGROUND: Although 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. METHODS: This 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. RESULTS: Total 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. CONCLUSIONS: Even 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 REGISTRATION: UMIN000036029. BioMed Central 2020-10-15 /pmc/articles/PMC7559194/ /pubmed/33059648 http://dx.doi.org/10.1186/s12887-020-02379-0 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Ito, Shuichi
Torii, Tomoko
Nakajima, Akihiro
Iijima, Takeshi
Murano, Hiroshi
Horiuchi, Hideki
Yamanaka, Hisashi
Honda, Masataka
Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database
title Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database
title_full Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database
title_fullStr Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database
title_full_unstemmed Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database
title_short Prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a Japanese health insurance database
title_sort prevalence of gout and asymptomatic hyperuricemia in the pediatric population: a cross-sectional study of a japanese health insurance database
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559194/
https://www.ncbi.nlm.nih.gov/pubmed/33059648
http://dx.doi.org/10.1186/s12887-020-02379-0
work_keys_str_mv AT itoshuichi prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT toriitomoko prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT nakajimaakihiro prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT iijimatakeshi prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT muranohiroshi prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT horiuchihideki prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT yamanakahisashi prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase
AT hondamasataka prevalenceofgoutandasymptomatichyperuricemiainthepediatricpopulationacrosssectionalstudyofajapanesehealthinsurancedatabase