OBJECTIVES: Limited real-world evidence exists on the healthcare burden of patients with uncontrolled gout in the USA. This study assessed the burden of uncontrolled gout among patients treated in routine clinical practice.

METHODS: This retrospective study identified patients considered to have uncontrolled gout (≥3 flares within 18 months with accompanying treatment or ≥1 pegloticase prescription(s) following gout diagnosis) between June 2011 and May 2020 from a US health plan claims database (IQVIA PharMetrics^® Plus). 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 healthcare resource utilization were examined, and presented for patients with baseline serum uric acid (sUA) level ≥6.0 mg/dL and ≥2 sUA results ≥6.0 mg/dL during follow-up.

RESULTS: The overall study criteria were met by 95,369 patients. Of these, 969 patients had a reported sUA level ≥6.0 mg/dL during baseline; 157 (85.4% male; median age 56.1 years) patients additionally had ≥2 sUA results ≥6.0 mg/dL during follow-up. Median time from index date to first and last sUA test during follow-up was 57 days and 263 days, respectively.

Of the 157 patients, the prevalence of common comorbidities (baseline and follow-up) was: hypertension (64.3% and 73.9%), joint pain (48.4% and 47.8%), dyslipidemia (40.8% and 49.7%), obesity (24.2% and 35.7%), type 2 diabetes (21.0% and 26.1%), and renal disease (20.4% and 24.8%); the proportion of patients with tophi was 4.5% and 8.9%, respectively. Ten (6.4%) patients experienced ≥1 gout-related hospitalization (median length of stay per admission 6.0 days). Further, 24 (15.3%) and 157 (100.0%) had ≥1 emergency room (ER) and outpatient gout-related visit (median number of outpatient visits 5.0), respectively.

CONCLUSIONS: Uncontrolled gout confers a high burden on patients and the US healthcare system; ~1 in 6 patients made ≥1 ER visit, and all patients made gout-related outpatient visits.