SAT0429 COMORBIDITIES IN AN EARLY DIAGNOSED COHORT OF UNCONTROLLED VERSUS CONTROLLED GOUT: ANALYSIS OF A LARGE US PAYER DATABASE

Abstract

Background Gout is a widely prevalent progressive systemic inflammatory arthritis. The pathogenic cause of gout is elevated serum uric acid or hyperuricemia, and appropriate treatment of gout involves reduction of uric acid levels to a minimum goal of less than 6 mg/dL. Patients who do not achieve uric acid goals are generally described as uncontrolled gout patients and tend to do worse in terms of clinical outcomes such as occurrence of flares and persistence/worsening of tophi. Gout patients often suffer from specific comorbidities, though whether uncontrolled gout patients have a different comorbidity profile is unclear. Objectives The objectives of this evaluation were to compare the comorbidities and hospitalizations in uncontrolled versus controlled gout patients from a large de-identified US payer database. Methods A retrospective review of Humana Healthcare data from 2007 to 2016 in private pay and Medicare patients was performed to identify patients with at least 1 gout ICD 10/ICD 9 diagnosis code (N=539,802) and 90 days of continuous urate-lowering therapy within 1 year of diagnosis. Two cohorts of patients were categorized according to their sUA levels (≥ 1 test) after at least 90 days of gout therapy: sUA Results The controlled gout group (sUA Conclusion Gout patients frequently suffer from cardiovascular and renal diseases. This large retrospective analysis suggests that when divided based on uric acid levels attained, uncontrolled gout patients are more likely to suffer from CKD and also more likely to be hospitalized for acute renal failure than controlled gout patients. Whether hyperuricemia in uncontrolled gout causes the development of specific cardiovascular and renal comorbidities, or if specific cardiovascular and renal diseases lead to hyperuricemia and uncontrolled gout is not fully established.