Real-world treatment patterns of gout patients treated with colchicine or other common treatments for gout in acute care settings: a retrospective chart review study

Abstract

Objective:

To describe real-world treatment patterns of patients receiving colchicine or other treatments during a gout-related emergency room or acute care facility (ER/ACF) visit.

Methods:

An online physician-administered questionnaire was used to collect chart data on 500 patients with a gout-related ER/ACF visit after 16 October 2009; 250 patients receiving colchicine (Colchicine Cohort) and 250 receiving NSAIDs, systemic corticosteroids, narcotics, allopurinol, febuxostat, pegloticase, probenecid, or sulfinpyrazone (Other Cohort). Patient characteristics and treatment received/prescribed during the ER/ACF visit (Period 1 [P1]), at discharge (P2), and at the first follow-up visit (P3) are reported.

Results:

A total of 45 rheumatologists and 63 primary care physicians participated in the study. Patient mean age was 51 years and 74.8% were male. The most common treatments in the Other Cohort were NSAIDs (59.6%), systemic corticosteroids (45.2%), and narcotics (33.6%). The 500 patients contributed 307 distinct treatment patterns from P1 to P3. Of the 20.6% patients not prescribed a treatment in P2, 60.2% were restarted on a treatment in P3. Of the 78.6% treated patients in P2, 27.0% had a treatment adjustment (dose increase, treatment add-on, or initiation of a different gout-related treatment – not with a urate lowering therapy only) in P3; for 72.6% of these patients, physicians justified the treatment adjustment by inadequacy of the treatment for maintenance therapy, insufficient dosage, or inadequate response. In the Colchicine Cohort, 60.8% of patients were prescribed colchicine consistently from P1 to P3, while 26.8% and 17.7% of patients in the Other Cohort were prescribed consistently NSAIDs and systemic corticosteroids from P1 to P3, respectively.

Limitations:

Specific nature of the acute gout-related symptoms or potential attack/flare during the ER/ACF visit was not recorded.

Conclusion:

Real-world clinical practice reveals a substantial number of distinct treatment patterns and frequent treatment adjustments by treating physicians for patients with a gout-related ER/ACF visit.

Keywords: :

• Colchicine
• Critical care
• Gout
• Patient care management
• Physician’s practice patterns
• Therapy

Transparency

Declaration of funding

This study was sponsored by Takeda Pharmaceuticals International Inc., which manufactures colchicine.

Declaration of financial/other relationships

A.S. and R.J. have disclosed that they are employees of Takeda Pharmaceuticals International Inc. M.C., J.H., A.G., and E.Q.W. have disclosed that they are employees of Analysis Group Inc., which has received consultancy fees from Takeda Pharmaceuticals International Inc. to conduct this study.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgments

Previous presentation: Selected materials from this paper were presented at the Academy of Managed Care Pharmacy (AMCP) 27th annual meeting, San Diego, CA, 7–10 April 2015.

Notes

* Colcrys is a trademark of Takeda Pharmaceuticals USA Inc. registered with the US Patent and Trademark Office and used under license by Takeda Pharmaceuticals America Inc.