The Majority of Gout Patients on Uric Acid Lowering Therapy Fail to Achieve Control of Serum Urate Levels Despite the Availability of Newer Treatment Options Such as Takeda's Uloric, Menarini/Ipsen's Adenuric and Savient Pharmaceuticals' Krystexxa
EXTON, Pa.--(BUSINESS WIRE)--Nov 29, 2011 - Rheumatologists and Primary Care Physicians (PCP's) in the U.S. and Europe recognize the importance of tight uric acid control as a strategy to minimize gout flares. However, despite physicians' emphasis on using uric acid lowering (UAL) therapies to reach therapeutic levels, the majority of gout patients have serum uric acid (SUA) levels above the therapeutic target of 6.0mg/dl. The findings come from two recent reports by BioTrends Research Group, ChartTrends®: Gout U.S. and ChartTrends®: Gout Europe in which over 2,500 gout patient charts were analyzed.
Allopurinol remains the predominant first-line UAL agent of choice among PCPs and rheumatologists, although Uloric/Adenuric (febuxostat) is making inroads, particularly in the more severe gout patients. The 300mg dose of allopurinol is still the most commonly prescribed strength in both markets and many physicians are reluctant to escalate allopurinol doses due to concerns regarding the patient's renal function and tolerability. Doses of Uloric in the U.S. were significantly higher compared to the same period last year and, among rheumatologists, doses of Adenuric in the EU are significantly higher than those in the U.S. for both moderate and severe patients.
In the U.S. audit, patient profiles revealed that Uloric and Krystexxa patients tend to have greater disease severity with polyarticular tophi, greater likelihood of kidney damage, and a greater frequency of acute gout flares, emergency room visits and hospitalizations compared to allopurinol patients. In the EU, where Krystexxa is not yet commercially available, significant differences exist between patients being treated with allopurinol and those being treated with Adenuric in terms of disease severity, flare frequency and severity, underlying co-morbidities and concomitant steroid use. EU physicians report that more than one-third of their severe gout patients have a suboptimal response to current UAL agents, highlighting a large opportunity for new products.
There is a significant difference in the use of colchicine to prevent paradoxical gout flares during UAL initiation between the U.S. and the EU among rheumatologists. Generic colchicine has been removed from the U.S. market in favor of the branded version, Colcrys, marketed by URL Pharma. Compared to one year ago in the U.S., the use of colchicine/Colcrys as prophylaxis is down sharply in prevalence among rheumatologists, but treatment duration is slightly higher than the prior year. Comparatively in the EU market, the percent of rheumatologists' patients receiving prophylactic treatment with colchicine was more common.
ChartTrends®: Gout is an annual, quantitative publication based on patient and laboratory data collected from over 1,200 gout patient charts in each market. It is designed to compare what physicians self-report about disease management to what actually occurs at the patient level. The reports provide insight into the factors that drive decisions to treat, brand selection of UAL therapies, patient characterizations, and dosing trends among primary care physicians and rheumatologists. Through an in-depth review of specific patient charts, details such as product initiation, switching, concomitant medications, acute gout flare management, and patient demographic variables help define patient types and identify therapy drivers. Patient profiles for the marketed UALs as well as products in late stage clinical development for gout (Regeneron's Arcalyst, Ardea's RDEA594, Biocryst's BCX4208) are characterized.
ChartTrends®: Gout U.S. 2011 report captures information from 1245 patient charts provided by 124 PCPs and 125 rheumatologists in October 2011. All patients are on a UAL therapy at the time of the audit with all UAL brands (Allopurinol, Uloric, Krystexxa) represented.
ChartTrends®: Gout Europe 2011 is a parallel report covering the European market (EU5) and captures information from 1260 patient charts provided by 126 general practitioners and 126 rheumatologists in August 2011. All patients are on a UAL therapy at the time of the audit with all UAL brands (Allopurinol, Adenuric, Probenecid, Sulfinpyrazone, Benzbromarone) represented.
About BioTrends Research Group, LLC
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Posted: November 2011