Epidemiology, Treatment Patterns, and Burden of Illness for Refractory Gout in Ontario
Summary
Client: IQVIA Solutions Canada Inc.
Project ID: P2025-247/ 2026 0980 015 000
Research Question/Objectives: Gout is a chronic inflammatory arthritis caused by urate crystal deposits due to persistent hyperuricemia. While most patients respond to urate-lowering therapy (ULT), some develop refractory gout, characterized by ongoing flares, high serum uric acid levels, and tophaceous disease despite treatment. This group faces significant clinical and economic burdens and is underrepresented in research (Baraf et al. 2013; FitzGerald et al. 2020). Over 680,000 Canadians have gout, with 54,000 new cases annually, mostly older males (Public Health Agency of Canada 2020). Treatment is often suboptimal, with only 22% on ULT (Rai, Aviña-Zubieta, McCormick, De Vera, Shojania, et al. 2017). Biologics like pegloticase are not currently available in Canada, limiting treatment options for patients with refractory gout. Globally, refractory gout’s burden is rising, with increased flares, tophi, and healthcare needs. Studies show these patients have higher healthcare costs and hospitalization rates (Francis-Sedlak et al. 2021; Morlock et al. 2025). Real-world evidence on refractory gout in Canada is limited, highlighting the need for studies using health data to identify and assess these patients. This study aims to use Ontario’s health data to identify refractory gout patients, analyze treatment patterns, and evaluate their clinical and economic burden, as well as absenteeism and productivity loss through a patient survey.
Objectives:
Research question: What is the incidence, prevalence, clinical and economic burden of treatment refractory gout (hereafter “refractory gout”) in Ontario, Canada?
Primary Objective(s):
- 1. Describe the incidence and prevalence of refractory gout in Ontario administrative data.
- Describe demographic and clinical profiles of patients with refractory gout in Ontario administrative data.
- Describe the treatment patterns of refractory gout patients within the Ontario Drug Benefits (ODB) plan.
- Describe all-cause and gout-related HCRU and associated costs for refractory gout patients and their matched controls with controlled gout in Ontario administrative data.
- Describe the impact of refractory gout on absenteeism and productivity loss among self-identified refractory gout patients.
Exploratory Objective(s):
- Stratify the primary objectives based on gout severity.
- Assess the primary objectives in patients with probable refractory gout in Ontario administrative data, if feasible
Status: In progress