OBJECTIVES: There is limited real-world evidence on the treatment patterns of patients with uncontrolled gout in the USA. This study assessed the treatment patterns associated with management of uncontrolled gout among US patients treated in routine clinical practice.

METHODS: This study was a retrospective analysis of a US health plan claims database (IQVIA PharMetrics^® Plus). Adult patients (≥18 years) considered to have uncontrolled gout (≥3 flares within 18 months with accompanying treatment or ≥1 pegloticase prescription(s) following gout diagnosis) were identified between June 2011 and May 2020. Patients were followed from 6 months before (baseline) to 12 months after (follow-up) the earliest date of uncontrolled gout (index date). Demographics, clinical characteristics, and treatment patterns were examined, and are presented here for a subpopulation of patients with a serum uric acid (sUA) level ≥6.0 mg/dL during baseline.

RESULTS: A total of 95,369 patients met the study criteria. Of those with reported sUA levels at baseline (n=1,289), 969 patients (87.2% male; median age 54.7 years) had an sUA level ≥6.0 mg/dL during the baseline period. Common comorbidities for these patients included hypertension (59.1%), joint pain (40.8%), dyslipidemia (34.9%), obesity (20.5%), type 2 diabetes (16.6%), and renal disease (15.0%). Tophi were reported in 50 (5.2%) patients. Patients received a median (range) of 2.0 (0.0–5.0) treatments during the follow-up period: 70.5% received allopurinol; 11.8% received febuxostat; 0.9% received pegloticase; 59.3% received prescription non-steroidal anti-inflammatory drugs; and 77.0% received steroids. Of these 969 patients, 490 had ≥2 reported sUA results during follow-up, of which 210 (42.9%) achieved control of their sUA level (≥1 sUA <6.0 mg/dL) at any point during follow-up.

CONCLUSIONS: In this population of patients with uncontrolled gout, recorded sUA levels were <6.0 mg/dL at some point during the follow-up period in less than half of patients, representing a high unmet need for new effective treatments.