Characteristics, Comorbidities, and Potential Consequences of Uncontrolled Gout: An Insurance-Claims Database Study
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ORIGINAL RESEARCH
Characteristics, Comorbidities, and Potential Consequences of Uncontrolled Gout: An InsuranceClaims Database Study Megan Francis-Sedlak
. Brian LaMoreaux . Lissa Padnick-Silver
.
Robert J. Holt . Alfonso E. Bello
Received: October 15, 2020 / Accepted: November 16, 2020 Ó The Author(s) 2020
ABSTRACT Introduction: Gout is a common, progressive, systemic inflammatory arthritis caused by hyperuricemia. Current guidelines recommend that serum uric acid (sUA) levels be maintained below 6.0 mg/dl to minimize acute gout attacks, tophi development, and long-term joint and organ damage. This study examined the influence of uncontrolled gout on post-diagnosis comorbidities and medication use. Methods: The Humana Research Database (2007–2016, commercial insurance and Medicare) was searched (PearlDiver tool) for patients who had a gout diagnosis code, claims data for at least 6 months before and after diagnosis, and at least 90 days of continuous urate-lowering therapy within 1 year of diagnosis. Patients with controlled (all sUA measurements \ 6.0 mg/dl) and uncontrolled (all sUA measurements C 8.0 mg/dl) gout were further examined and compared to better understand the influence of uncontrolled gout on post-diagnosis
M. Francis-Sedlak (&) B. LaMoreaux L. Padnick-Silver R. J. Holt Horizon Therapeutics plc, 150 South Saunders Road, Lake Forest, IL 60045, USA e-mail: [email protected] A. E. Bello Illinois Bone and Joint Institute, 2401 Ravine Way, Glenview, IL 60025, USA
comorbidities, medication use, and reasons for seeking medical care. Results: A total of 5473 and 1358 patients met inclusion and classification criteria for the controlled and uncontrolled groups, respectively. Identified comorbidities in both groups included hypertension, hyperlipidemia, diabetes, cardiovascular disease, and chronic kidney disease (CKD). However, the uncontrolled group was more likely to have diabetes, CKD, and cardiovascular disease (including heart failure and atrial fibrillation). Additionally, CKD tended to be more advanced in the uncontrolled gout population (Stage 4–5: 34.6 vs. 22.2%). Overall opioid use was higher in uncontrolled patients. Conclusions: The current study identified differences between controlled and uncontrolled gout patients, including usage of medication, severity of CKD, and prevalence of CKD, diabetes, and heart disease. Keywords: Gout comorbidities; gout; Uncontrolled gout
Refractory
PLAIN LANGUAGE SUMMARY Gout is a common, inflammatory arthritis caused by high uric acid levels in the blood. Serum uric acid (sUA) levels should remain below 6.0 mg/dl to reduce the number of gout flares, tophi development (urate build-ups on
Rheumatol Ther
bones and in joints), and long-term joint and organ damage. This study examined insurance claims (2007–2016 Humana Research Database) to see if there were differences between patients with uncontrolled (sUA C 8.0 mg/dl) and controlled (sUA \ 6 mg/dl) gout in comorbidities, medication use, and reasons for seeking medical care.
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