November 8, 2017

Gout Is Uncontrolled in Most US Patients

By Jill Stein

SAN DIEGO -- November 8, 2017 -- In most community-dwelling adults in the United States who report having gout, the condition is not controlled, regardless of kidney disease stage, researchers reported here on November 6 at the 2017 Annual Meeting of the American College of Rheumatology/Association of Rheumatology Health Professionals (ACR/ARHP).

Jean J. Lim, PhD, Tufts University School of Medicine, Boston, Massachusetts, and colleagues estimated the prevalence of chronic kidney disease (CKD) among US adults who had controlled (serum uric acid [SUA] <6 mg/dL) and uncontrolled (sUA ≥6 mg/dL) grout using data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2012.

Of the 715 patients, 74% had kidney function of normal to stage 2 CKD, 15% had stage 3a CKD, and 11% had stage 3b to 5 CKD. Of these patients, 22%, 42%, and 44%, respectively, were currently taking a xanthine oxidase inhibitor (XOI), usually allopurinol.

Most patients had uncontrolled gout regardless of CKD stage. Of patients with normal to Stage 2 CKD, 44% of those who were taking an XOI had uncontrolled gout and 88 % of those who were not a taking an XOI had uncontrolled gout. Of the patients with stage 3a CKD, the rates were 36% and 80%, and of the patients with stage 3b to 5 CKD, the rates were 57% and 83%.

Of patients taking an XOI, 34% were uncontrolled and had normal to stage 3a CKD.

Dr. Lim cautioned that gout status was self-reported, making its assessment subject to patients’ recall bias.

In addition, the use of febuxostat, was only captured in the 2011 to 2012 study cycle. Therefore, the results may have underestimated the percentage of patients currently using an XOI.

Finally, the results are only generalisable to non-institutionalised adults in the United States, which means that the analysis excluded individuals who were severely ill or very old.

Funding for this study was provided by Ironwood Pharmaceuticals, Inc.

[Presentation title: Prevalence of Chronic Kidney Disease and Uncontrolled Serum Uric Acid Levels in US Adult Gout Population: Results from the National Health and Nutrition Examination Survey 2007-2012. Abstract 1122]

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