Study reveals rise in gout patients
The UK has the highest rate of gout - often called the "disease of kings" - in Europe, figures suggest.
Experts found that one in 40 people across the UK is affected by the condition, with the highest rates in Wales and the North East of England.
Gout has historically been regarded as a rich man's complaint owing to its link to overindulgence on food and alcohol.
While many experts now regard this is an oversimplification, it is clear that drinking too much and being obese are factors in its development. Other factors include having high blood pressure or diabetes, having close relatives with gout or having long-term kidney problems.
Gout is caused by a build-up of uric acid in the blood. Uric acid is a waste product that is usually excreted by the body. If somebody produces too much uric acid, or too little is excreted in urine, it can build up and cause tiny crystals to form in and around joints.
These hard, needle-shaped crystals are formed slowly over several years.
The most common symptom is sudden and severe pain in the joint, alongside swelling and redness. A form of acute arthritis, gout most commonly affects the big toe, but may also be found in the heel, ankle, hand, wrist or elbow.
The latest research, published online in the Annals of the Rheumatic Diseases, involved analysing patient data to estimate how common gout was from 1997 to 2012.
Among more than 4.5 million people on the database in 2012, almost 116,000 already had gout, giving a prevalence of 2.5%.
Men were significantly more likely to have been diagnosed with the condition than women, peaking at a ratio of 11:2 between the ages of 35 and 39.
More than 7,000 new diagnoses of gout were also identified by researchers.
Between 1997 and 2012, the prevalence of gout rose by 64%, increasing by around 4% every year. Rates were around four times higher in men across the entire period.
The number of new cases rose by 30% during this time, increasing by around 1.5% each year.
Only around half of patients in 2012 were receiving any treatment or consultation. Furthermore, not enough patients (only around a third) were given treatment to lower levels of uric acid.
The authors said: " In recent years, both the prevalence and incidence of gout have increased signiﬁcantly in the UK.
"Suboptimal use of urate-lowering treatment has not changed between 1997 and 2012. Patient adherence has improved during the study period, but it remains poor."
In 2012, fewer than one in five patients were prescribed urate-lowering drugs within six months of their diagnosis, while one in four was on this treatment a year after diagnosis.
The experts, including a team from the University of Nottingham, said the management of "gout patients has remained essentially the same over the past 16 years".
They said the prevalence of gout in the UK is higher than recent estimates in other European countries, speciﬁcally Germany and Italy.