Dr. Schmidt has received consulting fees, speaking fees, and/or honoraria (less than $10,000 each) from Berlin Chemie-Menarini, Daiichi-Sankyo, Fresenius Medical Care, and Novartis.
Clinical and Health Care Use Characteristics of Patients Newly Starting Allopurinol, Febuxostat, and Colchicine for the Treatment of Gout
Article first published online: 27 NOV 2013
Copyright © 2013 by the American College of Rheumatology
Arthritis Care & Research
Volume 65, Issue 12, pages 2008–2014, December 2013
How to Cite
Kim, S. C., Schmidt, B. M. W., Franklin, J. M., Liu, J., Solomon, D. H. and Schneeweiss, S. (2013), Clinical and Health Care Use Characteristics of Patients Newly Starting Allopurinol, Febuxostat, and Colchicine for the Treatment of Gout. Arthritis Care Res, 65: 2008–2014. doi: 10.1002/acr.22067
- Issue published online: 27 NOV 2013
- Article first published online: 27 NOV 2013
- Accepted manuscript online: 16 JUL 2013 10:02AM EST
- Manuscript Accepted: 21 JUN 2013
- Manuscript Received: 6 MAR 2013
- NIH. Grant Numbers: K23-AR059677, K24-AR055989, P60-AR047782, R21-DE018750, R01-AR056215
Gout is a common form of inflammatory arthritis with an increasing prevalence in developed countries. It is well known that many patients with gout have significant comorbidities and high health care utilization. We aimed to describe the clinical characteristics and health care utilization patterns in patients with gout who were newly prescribed allopurinol, febuxostat, or colchicine.
We used US insurance claims data (2009–2011) to conduct a population-based cohort study.
There were 25,051 allopurinol, 4,288 febuxostat, and 6,238 colchicine initiators. The mean age was 53 years and 83–87% were men. More than one-half of the patients had hypertension and hyperlipidemia, 20% had diabetes mellitus, and 10% had cardiovascular disease. The mean uric acid level was similar across the groups at baseline, ranging from 8.1–8.5 mg/dl. Compared with allopurinol or colchicine initiators, febuxostat initiators had more comorbidities and greater health care utilization, including outpatient, inpatient, or emergency room visits, both at baseline and during followup. Use of gout-related drugs such as opioids, steroids, and nonsteroidal antiinflammatory drugs was most common in febuxostat initiators and least common in colchicine initiators. The median daily doses at both the start and end of treatment were 300 mg for allopurinol, 40 mg for febuxostat, and 1.2 mg for colchicine. The doses of allopurinol and febuxostat were rarely increased during followup.
Patients who started allopurinol, febuxostat, or colchicine for gout generally had hyperuricemia and multiple comorbidities. Febuxostat initiators had more comorbidities and greater use of health care resources and gout-related drugs than the other groups. Overall, the doses of allopurinol or febuxostat remained unchanged over time.