article · The Lancet Rheumatology
An analysis of the Global Burden of Disease Study 2021 provides global, regional, and national estimates of gout prevalence and years lived with disability from 1990 to 2020, with forecasts up to 2050. In 2020, approximately 55.8 million people worldwide lived with gout, representing a 22.5 percent rise in age-standardised prevalence since 1990. The condition was more than three times more prevalent in males than females and increased with age. High body mass index contributed to 34.3 percent of disability years caused by gout, whilst kidney dysfunction accounted for 11.8 percent. Driven mainly by population growth and ageing, cases are projected to rise by over 70 percent to 95.8 million by 2050. Managing this future burden requires lifestyle changes targeting weight reduction alongside wider access to flare prevention and control, though estimates for lower-income regions remain constrained by limited primary data.
Gout is a painful and disabling inflammatory arthritis that is becoming increasingly common across the globe. Understanding long-term trends and key risk factors, notably elevated body mass index, helps healthcare systems anticipate substantial increases in demand. Projecting cases to 2050 highlights a pressing requirement for population-level weight management strategies alongside broader access to medical therapies that control and prevent debilitating joint flares.
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BACKGROUND: Gout is an inflammatory arthritis manifesting as acute episodes of severe joint pain and swelling, which can progress to chronic tophaceous or chronic erosive gout, or both. Here, we present the most up-to-date global, regional, and national estimates for prevalence and years lived with disability (YLDs) due to gout by sex, age, and location from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, as well as forecasted prevalence to 2050. METHODS: Gout prevalence and YLDs from 1990 to 2020 were estimated by drawing on population-based data from 35 countries and claims data from the USA and Taiwan (province of China). Nested Bayesian meta-regression models were used to estimate prevalence and YLDs due to gout by age, sex, and location. Prevalence was forecast to 2050 with a mixed-effects model. FINDINGS: In 2020, 55·8 million (95% uncertainty interval 44·4-69·8) people globally had gout, with an age-standardised prevalence of 659·3 (525·4-822·3) per 100 000, an increase of 22·5% (20·9-24·2) since 1990. Globally, the prevalence of gout in 2020 was 3·26 (3·11-3·39) times higher in males than in females and increased with age. The total number of prevalent cases of gout is estimated to reach 95·8 million (81·1-116) in 2050, with population growth being the largest contributor to this increase and only a very small contribution from the forecasted change in gout prevalence. Age-standardised gout prevalence in 2050 is forecast to be 667 (531-830) per 100 000 population. The global age-standardised YLD rate of gout was 20·5 (14·4-28·2) per 100 000 population in 2020. High BMI accounted for 34·3% (27·7-40·6) of YLDs due to gout and kidney dysfunction accounted for 11·8% (9·3-14·2). INTERPRETATION: Our forecasting model estimates that the number of individuals with gout will increase by more than 70% from 2020 to 2050, primarily due to population growth and ageing. With the association between gout disability and high BMI, dietary and lifestyle modifications focusing on bodyweight reduction are needed at the population level to reduce the burden of gout along with access to interventions to prevent and control flares. Despite the rigour of the standardised GBD methodology and modelling, in many countries, particularly low-income and middle-income countries, estimates are based on modelled rather than primary data and are also lacking severity and disability estimates. We strongly encourage the collection of these data to be included in future GBD iterations. FUNDING: Bill & Melinda Gates Foundation and the Global Alliance for Musculoskeletal Health.
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DOI: 10.1016/s2665-9913(24)00117-6
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