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Abstract: FR-PO921

Projected Benefits of Gout Control on the Health and Economic Burden of CKD Patients with Uncontrolled Gout

Session Information

Category: CKD (Non-Dialysis)

  • 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention


  • Marder, Brad Allan, Horizon Therapeteutics plc, Deerfield, Illinois, United States
  • Card-Gowers, Joshua, HealthLumen Ltd, London, United Kingdom
  • Retat, Lise, HealthLumen Ltd, London, United Kingdom
  • Piotrowski, Marek, HealthLumen Ltd, London, United Kingdom
  • Webber, Laura, HealthLumen Ltd, London, United Kingdom
  • LaMoreaux, Brian, Horizon Therapeteutics plc, Deerfield, Illinois, United States
  • Kumar, Ada, Horizon Therapeteutics plc, Deerfield, Illinois, United States

Gout affects 1 in 4 patients with stage 3-5 CKD and is an independent risk factor for CKD progression. Since oral urate lowering therapies (ULTs) cannot adequately manage gout in some CKD patients, this study examines potential benefits of pegloticase treatment in CKD patients with refractory gout.


A validated microsimulation model was used to project gout burden in a virtual US CKD population. In the baseline scenario, individuals were assigned an eGFR, albuminuria status, and serum urate (SU) level. Those with gout were assigned complication risks for stroke, diabetes, and hypertension, direct and indirect costs, oral ULT use/efficacy probability (use: 29.9-41.9% [based on eGFR], efficacy: 48.3%) and utility weight. In the intervention scenario, patients with uncontrolled gout (SU>6 mg/dL despite oral ULT, and ≥2 gout flares/year or ≥1 tophi) were “treated” with pegloticase, assuming a 71% SU-lowering efficacy rate (SU<6mg/dL) through simulation end. Health/economic benefits were projected through 2035.


Prevalence of comorbid gout and CKD was projected to rise from 8.2M in 2023 to 10.5M in 2035, with 28% having uncontrolled gout. Annual costs of gout in CKD patients were projected to rise from $39.1B in 2023 to $50.4B in 2035. Pegloticase use in all CKD patients with uncontrolled gout resulted in 301,000 fewer uncontrolled gout cases, 208,000 quality-adjusted life years gained, and 53,000 complications avoided by 2035 (Figure). Compared to the baseline (non-treatment) scenario, intervention scenario costs were $23.4B lower in 2035.


Gout prevalence in CKD patients is projected to markedly increase over the next 12 years. This microsimulation suggests that intervention could result in health and quality of life improvements in CKD patients with uncontrolled gout, with associated cost reductions.

Figure. Difference in incident complications in CKD pts between treated (intervention) and untreated (baseline) uncontrolled gout scenarios.


  • Commercial Support – Horizon Therapeutics plc