Majority of gout patients on uric acid lowering therapy fail to achieve control of serum urate levels report

While rheumatologists and primary care physicians (PCPs) in the USA recognize the importance of tight uric acid control as a strategy to minimize gout flares, the majority of gout patients have serum uric acid (SUA) levels above the therapeutic target of 6.0mg/dl even though most of them are being treated with uric acid lowering (UAL) therapy.

Interestingly, the majority of physicians surveyed report high satisfaction ratings for their patients’ responses to their current UAL therapies. The findings come from the recent, ChartTrends: Gout US report from Decision Resources unit BioTrends Research Group, in which over 1,100 gout patient charts were analyzed.

The majority of moderate and virtually all severe gout patients are treated with UAL therapy. Allopurinol (Prometheus Laboratories/GlaxoSmithKline’s Zyloprim/Zyloric, generics) remains the predominant first-line UAL agent of choice among PCPs and rheumatologists, although Takeda’s Uloric (febuxostat) has made inroads, particularly in the treatment of severe gout patients. The 300mg dose of allopurinol is still the most commonly prescribed strength and many physicians are reluctant to escalate allopurinol doses because they felt their patients had achieved their target SUA level. PCPs’ primary reason for not escalating the dose of allopurinol in severe patients is due to concerns regarding the patient’s renal function. In contrast, physicians tend to titrate the dose of Uloric as disease severity increases, with at least two-thirds of severe gout patients on Uloric taking 80mg or higher.