Table 5.
Factors Associated With Nonadherence to Allopurinol and sUA Goal Attainment from Logistic Multivariable Regression in New Allopurinol Users
| Study Covariates | Nonadherence* To Allopurinol During First 12 Months Versus Adherence | Patients Achieving sUA Goal** versus Not Achieving Goal |
|---|---|---|
| OR (95% CI) | OR (95% CI) | |
| Male (vs. female) | 1.04 (0.88,1.20) | 0.60 (0.52, 0.67) |
| Patient Age Groups, years | ||
| <55 | 1.22 (1.09,1.34) | 0.82 (0.78,0.92) |
| 55-64 | 0.87 (0.65,1.06) | 0.91 (0.85,1.06) |
| ≥65 (reference) | 1.00 | 1.00 |
| Race/Ethnicity | ||
| Caucasian (reference) | 1.00 | 1.00 |
| African American | 1.46 (1.32,1.61) | 0.80 (0.78,0.89) |
| Hispanic | 1.42 (1.35,1.62) | 0.86 (0.75,0.97) |
| Asian/Pacific Islander | 1.31 (1.21,1.38) | 0.79 (0.70,0.93) |
| Other | 1.21 (0.82,1.64) | 0.95 (0.93,1.05) |
| Comorbidities | ||
| Hypertension | 0.87 (0.71,0.95) | 1.02 (0.91,1.17) |
| Myocardial infarction | 0.89 (0.82,0.98) | 1.03 (0.84,1.22) |
| Congestive heart failure | 0.85 (0.75,0.97) | 0.68 (0.57,0.89) |
| Diabetes | 0.74 (0.67,0.82) | 0.91 (0.79,1.11) |
| CKD Stages | ||
| CKD Stage 1 (reference) | 1.00 | 1.00 |
| CKD Stage 2 | 0.95 (0.91,1.07) | 0.98 (0.88,1.10) |
| CKD Stage 3 | 1.15 (1.20,1.60) | 0.72 (0.65,0.88) |
| CKD Stage 4 | 1.60 (1.38,1.98) | 0.62 (0.54,0.75) |
| Other Covariates | ||
| Diuretic use | 0.75 (0.71, 0.85) | 0.95 (0.79, 1.05) |
| Use of baseline anti-inflammatory | 1.25 (1.19,1.37) | 0.75 (0.64, 0.89) |
| Rheumatologist as initial prescriber | 0.80 (0.74,0.87) | 1.72 (1.45,1.85) |
| Allopurinol Adherence (PDC≥80) | - | 2.52 (2.41,3.01) |
| Starting Allopurinol Total Dose, mg/day | ||
| ≤ 100 (reference) | 1.00 | 1.00 |
| >100 to < 300 | 1.20 (1.13,1.24) | 1.92 (1.86,2.22) |
| ≥ 300 | 1.10 (1.05,1.32) | 2.12 (1.81,2.55) |
*
Model included PDC for patients that had 2 or more allopurinol dispensings during 12 months post-index (N=10,991).
**
sUA goal is <6mg/dl anytime during post-index and was evaluated for patients with baseline and follow-up sUA levels (N=9,581) during observation.
Bold numbers indicate statistical significance; allopurinol dose escalation not included in multivariable models due its strong association with provider type (rheumatologist vs. non-rheumatologist). Odds ratio (OR); confidence interval (CI); chronic kidney disease (CKD); proportion of days covered (PDC).