Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics

EULAR 2020: A National Perspective of Gout and Heart Failure in the US Interview with:

Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics

Dr. LaMoreaux

Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics What is the background for this study?

Response: This is an independent study by Dr. Gurkipal Singh for which Horizon provided support and funding.

Heart failure is the eighth leading cause of death in the US, with a 38% increase in the number of deaths due to HF from 2011 to 2017. Dr. Gurkirpal Singh conducted this analysis on heart failure hospitalization rates in patients with gout in the US to estimate their clinical and economic impact. Gout and hyperuricemia have previously been recognized as significant risk factors for heart failure, but there is little nationwide data on the clinical and economic consequences of these comorbidities. What are the main findings?

Response: The results showed that the aging of the US population is projected to significantly increase the burden of illness and costs of care of these comorbidities – calling for an increased awareness and management of serious co-morbid conditions in gout patients. What should readers take away from your report?

Response: Dr. Singh’s report showed there were 35.8 million all-cause hospitalizations in patients in the US in 2017. Of these, 351,735 hospitalizations occurred for acute and/or chronic heart failure in patients with gout. These patients had a mean age of 73.3 years (95% confidence intervals 73.1 – 73.5 years) and were more likely to be male (63.4%). The average length of hospitalization was 6.1 days (95% confidence intervals 6.0 to 6.2 days) with a case fatality rate of 3.5% (95% confidence intervals 3.4% – 3.7%). The average cost of each hospitalization was $63,992 (95% confidence intervals $61,908 – $66,075), with a total annual national cost estimate of $22.8 billion (95% confidence intervals $21.7 billion – $24.0 billion). It is critical for those of us treating patients with gout to not only treat their condition to reduce urate burden, but also to recognize potential comorbidities to ensure their health is being managed from a comprehensive perspective and help minimize the risk of hospitalization. What recommendations do you have for future research as a result of this work?

Response: This study from 2017 showed a high volume of hospitalizations for gout and heart failure. As the U.S. population ages this number will likely increase. While we are starting to get a clear picture of the impacts comorbid conditions can have on uncontrolled gout patients and the health system, continued research is important to further assess the benefits of early intervention and proper treatment for uncontrolled gout, to provide more awareness in the rheumatology community around the lasting harmful effects uncontrolled gout can have on the body, especially in those with other conditions like heart failure. It’s also important for us to be cognizant of the high numbers of hospitalization for patients with gout and chronic heart failure so that we may, in turn, pay them more careful attention and potentially improve outcomes. 

Disclosures: I am a medical director at Horizon and a volunteer clinical rheumatologist with CommunityHealth.



  1. Singh1, M. Sehgal2, A. Mithal3

1Stanford University, Gastroenterology and Hepatology, Stanford, United States of America
2University of California Los Angeles, Los Angeles, United States of America
3Institute of Clinical Outcomes Research and Education (ICORE), Woodside,
United States of America


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Last Updated on June 14, 2020 by Marie Benz MD FAAD