Time Needed to Reach Goal Explored in Allopurinol-Treated Gout Patients

 Allopurinol has remained the most frequently prescribed ULT for decades
Allopurinol has remained the most frequently prescribed ULT for decades

Gout patients who do not reach a serum urate (sUA) goal of <6.0mg/dL within 1 year of using allopurinol at any starting dose may be unlikely to reach goal in the next year, according to data presented at the 2017 ACR/ARHP Annual Meeting.

"Reaching a goal of [sUA] level of <6.0mg/dL has been suggested by gout management guidelines," said lead author Jean Lim, MD. "However, limited studies have reported time duration needed to reach the sUA goal among allopurinol users." By conducting a retrospective study, the researchers looked to estimate the time needed for allopurinol-treated gout patients to reach sUA goal. 

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The study enrolled 1,404 patients aged ≥18 years with a gout diagnosis, at least 1 prescription fill during 2011-2015 (intake period, the earliest allopurinol date as index date), ≥90 days of allopurinol continuous therapy, and ≥2 sUA results.  Time to sUA goal was estimated from index date until reaching <6.0mg/dL. Those who did not reach sUA goal were followed until end of therapy, health plan disenrollment or end of 2015, whichever came first. 

The median time to sUA goal was 8 months. When stratified by initial dosage, the proportion of patients reaching sUA goal in 1 year was 36% vs. 49% in 2 years for <300mg. For initial doses ≥300mg, the proportion of patients reaching sUA goal was 65% in 1 year and 77% in 2 years.

The authors concluded that "Patients with gout who do not reach goal within 1 year using allopurinol, regardless of initial dosage, are unlikely to reach goal in the next year and therefore may benefit from additional treatment."

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