Gout| Treatment Algorithms | Claims Data Analysis | US | 2015

Chronic gout, estimated to affect 6.8 million U.S. adults, is a painful, inflammatory arthritis caused by high systemic levels of serum uric acid (sUA) resulting in hyperuricemia. Affected patients experience an intermittent pattern of acute flares, and disease management is aimed at providing short-term, immediate relief for acute flares and reducing the frequency of flares and the signs/symptoms of the disease using long-term urate-lowering therapy. Pharmacological treatment includes treatments for both acute attacks and chronic disease management; this report specifically examines the use of chronic gout treatments. Chronic gout treatment involves the use of urate-lowering drugs (ULDs) that prevent recurrent gout attacks by lowering the concentration of sUA to at least < 6="" mg/dl,="" or="" to="" a="" concentration="" that="" durably="" improves="" the="" signs/symptoms="" of="" gout,="" including="" palpable="" and="" visible="" tophi="" (often="">< 5="" mg/dl).="" leading="" ulds="" include="" xanthine="" oxidase="" inhibitors="" (xoi)="" (allopurinol="" [generics],="" takeda="" pharmaceutical’s="" uloric="" [febuxostat]),="" which="" prevent="" the="" synthesis="" of="" uric="" acid,="" and="" uricosuric="" drugs="" (probenecid="" [generics]),="" which="" increase="" the="" rate="" of="" excretion="" of="" uric="">

Using national patient-level claims data, Treatment Algorithms in Gout explores the use of key therapies and drug classes among newly diagnosed and recently treated gout patient populations. Among the newly diagnosed patients, we provide a quantitative analysis of percentage drug-treated and time to treatment, treatment patterns and share by line of therapy as well as progression between lines, recent patient share trends, and use of concomitant treatment. Among recently treated patients, we quantify a drug’s overall drug share, use in combination with other therapies, and source of business compared with its competitors, detailing which drugs precede others through an analysis of add-versus-switch patterns. Two additional claims database queries explore persistency and compliance by therapy.