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02-05-2018 | Rheumatology | News | Article

BSR 2018

Emergency hospitalizations rising for gout, falling for RA, SLE

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medwireNews: Rates of emergency hospitalizations for gout have increased in England in recent years, but have decreased for rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), suggest study findings presented at the 2018 British Society for Rheumatology Annual Conference in Liverpool, UK.

Presenting the results of the gout analysis, conducted using the NHS Digital database, Mark Russell (Kings College London, UK) told delegates that the incidence of unplanned gout hospitalizations was 12.5 per 100,000 people in 2017, a 59% increase from 7.9 per 100,000 people in 2006.

Emergency hospitalizations accounted for 82% of gout admissions over the period studied, and the average length of stay was 6.6 days. Russell also noted that the use of common gout medications increased from 2006 to 2017, with allopurinol prescriptions rising from 7387 to 12,697 per 100,000 people, and the number of prescriptions for febuxostat increasing 20-fold.

In contrast to these findings, unplanned hospital admissions for RA decreased by 50% over the same time period, from 8.6 to 4.3 admissions per 100,000 people, said Russell.

And in another analysis, Jennifer Hannah (Guys and St Thomas' NHS Trust, London) and colleagues demonstrated that emergency admissions for RA decreased from 12.8 per 100,000 people in 1998 to 4.4 per 100,000 people in 2014. Emergency hospitalizations for SLE decreased from 2.6 to 1.2 per 100,000 people over the same period, despite an overall increase in all-cause emergency admissions.

Hannah and colleagues also observed a “dramatic” reduction in the number of bed days for both RA and SLE from 1998 to 2014, which she hypothesized could be due to better therapies, improved access to specialist rheumatology teams, or greater availability of day facilities where treatment can be given.

While Hannah believes that “there has been a real revolution in the treatment” of patients with RA and SLE in recent years, Russell stressed that for gout, the increase in emergency hospitalizations is “a call to arms to rheumatologists to help reduce the inpatient burden” of this potentially curable condition.

By Claire Barnard

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