Gout in Southeast Asia: An Ancient Disease in a Region in Flux

Gout is one of the most common inflammatory arthritides worldwide, and its burden is rising in Southeast Asia alongside rapid demographic and socioeconomic transitions. This region, characterized by diverse healthcare systems, cultural practices, and levels of economic development, presents a unique context in which the epidemiology and management of gout are evolving. Despite the availability of effective urate-lowering therapy (ULT) and well-established treat-to-target (T2T) strategies, real-world outcomes remain suboptimal. Barriers to optimal gout care operate at multiple levels. Physician-related factors include clinical inertia and limited awareness of evidence-based recommendations. Patient-related factors include limited understanding of gout and its treatment, compounded by socioeconomic disadvantages. System-level challenges include inequitable access to healthcare services, limited health insurance coverage, and resource-strained health systems. The current evidence base in Southeast Asia remains limited and heterogeneous, raising uncertainty regarding the applicability of global data to local populations. Nevertheless, emerging studies suggest that multidisciplinary, context-oriented approaches can improve gout outcomes. The objective of this review is to explore the evolving epidemiological landscape and barriers to gout management in Southeast Asia.