Physicians frustrated, advocate for aggressive treatment for gout
patients, yet target goal of sUA < 6 mg/dL remains elusive
CAMBRIDGE, Mass.--(BUSINESS WIRE)--
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 Gout
Physicians
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 Action
While 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 Goal
The
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 Priorities
Of
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 Gout
Gout 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 Pharmaceuticals
Ironwood
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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