Background/Purpose: The impact of chronic gout and acute flares on daily activities is severely limiting. Yet only 40% of gout patients receive urate-lowering therapy (ULT), usually without titration to guideline targets (Doherty. Ann Rheum Dis 2012;71:1765-70; Kuo. Ann Rheum Dis 2015;74:661-7). Several barriers have been identified leading to suboptimal care. When patients are fully informed about their disease and involved in management decisions, uptake of ULT is higher and subsequent adherence can be improved (Rees. Ann Rheum Dis 2013:72:826-3). The aim of this study was to evaluate patient characteristics and key perceptions of gout in the US.

Methods: A 2017 cross-sectional survey of US adults assessed health conditions, health-related quality of life (HRQoL), and health care resource utilization. Participants aged ≥18 years were recruited using a random stratified sampling framework to ensure demographic composition representative of the US population. Participants who reported having gout completed a series of questions about current treatments, serum urate (sUA) laboratory assessments, disease severity, satisfaction with disease control, acute gout attacks (flares), and their own and physicians’ level of concern about their gout. Population level characteristics, treatments, sUA testing, and patient descriptions of burden of gout are summarized using descriptive statistics.

Results: A total of 372 (3.1%) of 12,146 participants reported having gout. Patients’ characteristics are presented in the Table. Less than half (42.5%) reported currently taking ULT. Of those on ULT, the majority (90.5%) reported taking allopurinol and, of these, most (83.8%) reported taking 300 mg or less/day. A total of 58.2% of those reported taking anti-inflammatory medication for their flares. Less than half (45.1%) had their sUA tested in the last 12 months and only 36.3% knew their test results. Among the tested, only 38.3% reported an sUA <6 mg/dL. Nearly 30% reported their condition as severe to very severe, and 22.7% reported a low concern. Despite the majority of patients failing to achieve target sUA goals, only 20% reported being dissatisfied with their treatment of gout. Patients described their gout pain as a “one of a kind, indescribable pain”; [like a] “broken or bruised bone”; “excruciating pain”; and “unbearable.” A summary and classification of patient quotes illustrates the extreme burden experienced by patients with gout.

Conclusion: In 2017 less than half of the gout patients from the US were being treated with ULT and the majority fell short of treatment goals, despite gout being described as one of the most debilitating painful conditions ever experienced. Improving the care for patients with gout continues to be a clear unmet need that can potentially reduce the severity of this disease, thus significantly impact HRQoL.