Morlock Robert J, Dalal Deepan, Divino Victoria, DeKoven Mitchell, Taylor Stephanie D, Powers Atsuko, Barretto Naina, Holt Robert J, LaMoreaux Brian
YourCareChoice, 2370 E. Stadium Blvd., Ann Arbor, MI, 48104, USA.
Division of Rheumatology, Brown University Warren Alpert Medical School, 725 Reservoir Ave Suite 204; Cranston, Providence, RI, 02910, USA.
Rheumatol Ther. 2025 Feb;12(1):37-51. doi: 10.1007/s40744-024-00723-9. Epub 2024 Nov 14.
Gout is a progressive form of arthritis that causes significant pain and disability. Patients with treatment-refractory (or uncontrolled) gout experience a higher prevalence and severity of comorbidities than those whose gout is controlled. Pegloticase is a recombinant PEGylated uricase indicated for the treatment of gout in patients refractory to conventional therapy. We evaluated the treatment journey of patients with chronic uncontrolled gout before initiation of pegloticase therapy.
Using IQVIA's PharMetrics Plus database, we conducted a retrospective observational analysis of adults with ≥ 1 pegloticase claim between April 1, 2011, and August 31, 2020. Demographics were assessed at baseline. Clinical outcomes, health care resource utilization (HCRU), and associated costs were compared over two 12-month periods (months 13-24 and 1-12) prior to the first pegloticase claim (index date).
The study included 408 patients. Prevalence of all gout-associated conditions increased between months 1-12 and 13-24 (P < 0.05 for all). The percentage of patients with tophi increased from 15.4% to 61.5%, the percentage with ≥ 1 flare increased from 49% to 84%, and mean number of flares per patient increased from 1.0 to 2.1 (P < 0.0001 for all). The frequency of all categories of HCRU except emergency department visits also increased (P < 0.0001 for all), as did gout-related healthcare utilization (P£0.005).
Patients with uncontrolled gout experienced an increase in the clinical burden of disease and HCRU in the 2 years before the initiation of pegloticase. Earlier patient identification and initiation of potentially effective therapy may help alleviate these burdens.
痛风是一种渐进性关节炎，会导致严重疼痛和残疾。与痛风得到控制的患者相比，治疗难治性（或未得到控制）痛风患者的合并症患病率更高，病情也更严重。培戈洛酶是一种重组聚乙二醇化尿酸酶，适用于治疗对传统疗法难治的痛风患者。我们评估了慢性未控制痛风患者在开始培戈洛酶治疗前的治疗历程。
利用艾昆纬公司的PharMetrics Plus数据库，我们对2011年4月1日至2020年8月31日期间有≥1次培戈洛酶用药记录的成年患者进行了回顾性观察分析。在基线时评估人口统计学特征。在首次培戈洛酶用药记录（索引日期）之前的两个12个月期间（第13 - 24个月和第1 - 12个月）比较临床结局、医疗保健资源利用（HCRU）及相关费用。
该研究纳入了408例患者。在第1 - 12个月至第13 - 24个月期间，所有痛风相关病症的患病率均有所增加（所有P < 0.05）。有痛风石的患者百分比从15.4%增至61.5%，有≥1次发作的患者百分比从49%增至84%，每位患者的发作平均次数从1.0增至2.1（所有P < 0.0001）。除急诊就诊外，所有HCRU类别的频率也都增加了（所有P < 0.0001），痛风相关医疗保健利用情况也是如此（P≤0.005）。
未控制痛风患者在开始培戈洛酶治疗前的2年中，疾病的临床负担和HCRU有所增加。更早地识别患者并启动可能有效的治疗可能有助于减轻这些负担。
