The non-fatal burden of gout in Belgium, 2023: evidence of age and sex disparities

Abstract Gout is the most common form of inflammatory arthritis with a great impact on healthcare systems. Despite advances in treatment, gout remains underdiagnosed and undertreated, and is associated with an increased risk of comorbidities. Therefore, quantifying the burden and pattern of gout cases by age and sex is necessary to efficiently address the current and needs. The current study aims to quantify the health burden of gout in Belgium using national data. As no single comprehensive data source on gout prevalence exists in Belgium, a critical appraisal of available local and national data sources was performed. The non-fatal burden of gout was estimated in terms of years lived with disability (YLDs) by combining prevalence data with corresponding disability weights. In line with the Global Burden of Disease (GBD) 2019 methodology, mortality attributable to gout was assumed to be zero. Therefore, total disability-adjusted life years (DALYs) equalled YLDs in this study. Based on qualitative and quantitative appraisal, a widespread network of general practitioners was identified as the best available national data source to identify gout cases. In 2023, the prevalence of gout in Belgium was estimated at 2.4%, with a significant sex disparity: 3.9% among men and 1% among women. The burden of gout accounted for 8,612 DALYs (73 DALYs per 100,000) nationally. The condition disproportionately affected men and individuals aged 50 and older. The burden of gout was comparable to that of bipolar disorder, multiple myeloma, and hearing loss in Belgium. Our prevalence and DALY estimates for gout in Belgium were, however, higher than those of the GBD study. Gout poses a substantial and growing non-fatal burden in Belgium, disproportionately affecting men and older individuals. The findings highlight the need for improved early detection, patient adherence to treatment, and integrated chronic disease management strategies to reduce long-term disability associated with gout. Key messages • National estimates of gout burden show that gout poses a significant non-fatal burden in Belgium, with pronounced disparities by sex and age. • Findings support the need for targeted public health strategies to improve gout prevention, diagnosis, and management, especially among high-risk groups.