Physicians frustrated, advocate for aggressive
treatment for gout patients, yet target goal of sUA <6 mg/dL
remains elusive
A new survey conducted among primary care physicians and
rheumatologists found that despite their overall agreement that
gout is a serious and chronic medical condition with potential
long-term consequences, patients remain at risk. Of physicians
surveyed, 89 percent agree that achieving serum uric acid (sUA)
levels <6 mg/dL is imperative, yet only 51 percent report their
patients with gout are reaching this target.
Further, nearly all (94 percent) of healthcare providers (HCPs)
surveyed indicate that gout needs to be treated aggressively given
long-term consequences, but express frustration (82 percent) when
treatments fail to control sUA levels. A majority (89 percent) of
physicians surveyed express a desire for additional treatment
options for their patients.
“What I find most concerning about these findings is that we as
physicians agree gout is not only a painful, often debilitating
disease, but can have long-term consequences like permanent joint
damage. Moreover, studies are showing a good deal of
association between gout and comorbid conditions such as
cardiovascular disease and kidney disease. Yet clinicians who treat
patients with gout are only getting about half of those patients to
their target sUA levels,” said Paul Doghramji, M.D., Family
Physician, Collegeville Family Practice, Collegeville, PA. “I think
there are two reasons why: we haven’t had enough treatment options
to help manage the disease and there are continued misconceptions
about gout that contribute to ineffective disease management.”
Gout is a highly symptomatic and painful form of inflammatory
arthritis caused by an underlying metabolic disorder, hyperuricemia
– or high uric acid levels in the blood – and can lead to painful
flares, characterized by excruciating pain, inflammation, swelling
and tenderness in one or more joints. Living with uncontrolled gout
can put patients at risk of long-term consequences such as
inflammation, bone erosion and organ damage. The American College
of Rheumatology (ACR) guidelines recommend gout patients maintain
sUA levels below 6 mg/dL, a target that remains elusive for
uncontrolled gout patients. The survey was conducted online among
healthcare professionals (250 primary care physicians and 100
rheumatologists) in August 2016 to gain insight into their
perceptions of and treatment practices for gout. Additional survey
findings include:
Knowledge Gap Exists Between Physicians and Patients with
GoutPhysicians surveyed take treating gout very seriously
because of the potential long-term effects of the disease, such as
joint damage (97 percent) and cardiovascular risks (83 percent).
Nearly all of these physicians (95 percent) say gout has
significant impact on patients’ physical abilities.
However, 90 percent of physicians surveyed agree that their gout
patients do not have a good understanding of the disease, and 95
percent say their patients’ focus remains on gout flares rather
than the long-term impact of the underlying disease, despite these
physicians’ efforts to educate their patients about the
disease.
Diet Misperceptions Prevail, Impact ActionWhile a
majority of physicians surveyed disagree with the statement that
diet is the primary contributor to elevated sUA levels, survey
findings indicated physicians put an emphasis on the role diet
plays, with 84 percent noting they focus on diet and nutrition as a
major area when treating patients with gout, and 75 percent stating
they believe most patients with gout could minimize the impact of
the disease if they had more control over their diet and alcohol
consumption.
Further, nearly half of these physicians indicate their patients
are not motivated to schedule follow-up visits to test their sUA
level after experiencing gout symptoms. Seven in ten feel their
patients accept painful flares or “attacks” as part of living with
gout.
“Physicians who treat gout tend to emphasize the role of diet
and nutrition with patients, especially since so many patients have
failed to reach their target sUA levels. But now it’s time to also
consider the importance of therapies that can help patients get to
their target sUA level,” said Dr. Doghramji. “Dispelling myths of
gout as a medieval ‘rich man’s diet’ disease, destigmatizing this
disease and optimizing available treatments is, in my view, the
most constructive path forward for the gout community.”
An Estimated 2 Million Patients in the U.S. Not at
GoalThe survey found that only 51 percent of physicians polled
report their patients with gout are reaching target sUA levels
below 6 mg/dL as recommended by ACR. Prevalence statistics indicate
that of the approximately four million U.S. gout patients treated
with a xanthine oxidase inhibitor (XOI) alone, approximately 50
percent are not able to maintain target sUA levels. This suggests
about two million patients in the U.S. are suffering from
uncontrolled gout.
Education, Getting Patients to Target sUA Levels Are
PrioritiesOf physicians surveyed, educating patients about the
long-term consequences of gout (75 percent) and encouraging
patients with gout to get their sUA levels to target even when not
experiencing flares (72 percent) are physicians’ main
priorities.
Findings also revealed key insights into how these physicians
believe their patients perceive the disease, providing
opportunities for further engagement and education. The survey was
supported by Ironwood Pharmaceuticals.
About Hyperuricemia and GoutGout is a highly symptomatic
and painful form of inflammatory arthritis affecting an estimated
eight million people in the U.S. It is caused by an underlying
metabolic disorder, hyperuricemia – high levels of uric acid in the
blood – and can lead to painful flares, characterized by
excruciating pain, inflammation, swelling and tenderness in one or
more joints. Gout is commonly hereditary and not only a lifestyle
disease. While diet and lifestyle changes are important in managing
gout and its comorbidities, they are often not enough to get
patient serum uric acid (sUA) levels to target.
Approximately four million patients are treated with a xanthine
oxidase inhibitor (XOI), either allopurinol or febuxostat, for gout
in the U.S. Of these, an estimated two million patients are
uncontrolled and are not achieving target serum uric acid (sUA)
levels <6 mg/dL as recommended by the American College of
Rheumatology, despite treatment with an XOI alone. These patients
continue to suffer from flares despite treatment with an XOI alone,
and may face serious long-term consequences that can result from
having uncontrolled sUA levels.
More information about gout is available at
www.goutisserious.com.
About Ironwood PharmaceuticalsIronwood
Pharmaceuticals (NASDAQ: IRWD) is a commercial biotechnology
company focused on creating medicines that make a difference for
patients, building value for our fellow shareholders, and
empowering our passionate team. We are advancing a pipeline of
innovative medicines in areas of significant unmet need, including
irritable bowel syndrome with constipation (IBS-C)/chronic
idiopathic constipation (CIC), uncontrolled gout, refractory
gastroesophageal reflux disease, and vascular and fibrotic
diseases. We discovered, developed and are commercializing
linaclotide, the U.S. branded prescription market leader in the
IBS-C/CIC category, and we are applying our proven R&D and
commercial capabilities to advance multiple internally-developed
and externally-accessed product opportunities. Ironwood was founded
in 1998 and is headquartered in Cambridge, Mass. For more
information, please visit
www.ironwoodpharma.com or www.twitter.com/ironwoodpharma;
information that may be important to investors will be routinely
posted in both these locations.
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Communicationstmorrison@ironwoodpharma.comorInvestor
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