Comorbidity Burden in Trial-Aligned Patients with Established Gout in Germany, UK, US, and France: a Retrospective Analysis

Autor: R. Morlock, Laura Horne, Pierre Chevalier, Dionne M. Hines, Xavier Ansolabehere, Lalitha Aiyer, C. Storgard, Fredrik Nyberg, Javier Nuevo
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Male
Pediatrics
Gout
Databases
Factual
Myocardial Infarction
Cardiovascular
Comorbidities
0302 clinical medicine
Serum uric acid
Germany
Retrospective analysis
Prevalence
Pharmacology (medical)
030212 general & internal medicine
Renal
media_common
Original Research
Medicine(all)
Incidence (epidemiology)
Incidence
General Medicine
Middle Aged
Cardiovascular Diseases
Female
Kidney Diseases
France
musculoskeletal diseases
Adult
medicine.medical_specialty
congenital
hereditary
and neonatal diseases and abnormalities
Pharmacology toxicology
03 medical and health sciences
medicine
media_common.cataloged_instance
Humans
European Union
European union
Aged
Retrospective Studies
030203 arthritis & rheumatology
business.industry
nutritional and metabolic diseases
Retrospective cohort study
medicine.disease
Comorbidity
United States
United Kingdom
Physical therapy
business
Zdroj: Advances in Therapy
ISSN: 1865-8652
0741-238X
Popis: Introduction Patients with gout have numerous comorbidities. We aimed to estimate the prevalence and incidence rates of renal and cardiovascular morbidities in trial-aligned patients with established gout in Germany (DE), the United Kingdom (UK), the United States (US), and France (FR). Methods This longitudinal cohort study used retrospective data from IMS Disease Analyzer™ (DE, FR), Clinical Practice Research Datalink–Hospital Episode Statistics (UK), and IMS’ PharMetrics Plus database linked with outpatient laboratory results (US). Included patients were ≥18 years at index date (January 1, 2010; all dates +1 year for FR), with continuous enrollment during the pre-index year, had “prevalent established gout” determined by data in the pre-index year, and ≥1 documented visit after index date; additional inclusion/exclusion criteria were aligned with recent gout clinical trials. Look-back for comorbidity prevalence extended to January 1, 2003 (US: January 1, 2009). Follow-up for incidence extended from index date to at most March 26, 2013 (FR: May 31, 2014). Events of interest were identified by diagnostic codes and/or laboratory data. Results The trial-aligned cohorts included 35,118 (DE), 24,607 (UK), 121,591 (US), and 17,338 (FR) patients. Among renal conditions, baseline diagnosis of chronic kidney disease/renal failure was most prevalent in the UK followed by DE; abnormal serum creatinine was most prevalent in the UK. Hypertension was the most prevalent cardiovascular diagnosis in all countries, followed by ischemic heart disease (IHD) and myocardial infarction. Incidence rates (per 100 patient-years) for new/worsening renal impairment ranged from 1.67 (DE) to 4.34 (US) and for nephrolithiasis diagnosis from 0.31 (FR) to 3.79 (US). The incidence rates for hypertension diagnosis were highest among cardiovascular-related events, ranging from 3.23 (UK) to 20.27 (US), followed by IHD. Conclusions Patients with established gout such as those included in gout trials have a high burden of established morbidity and new diagnoses of morbid events. Consideration of comorbidities, which greatly exacerbate disease burden, is important in gout management. Funding AstraZeneca. Electronic supplementary material The online version of this article (doi:10.1007/s12325-016-0346-1) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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