Chronic Gout Market

• The chronic gout market is anticipated to sustain a steady Compound Annual Growth Rate (CAGR) during the forecast period (2025–2034). This growth is driven by rising prevalence from aging and cardiometabolic comorbidities; improved diagnosis and awareness; an active R&D pipeline (xanthine oxidase inhibitors, uricosurics, recombinant uricases, targeted anti-inflammatories); wider use of advanced diagnostics; and greater healthcare spending plus unmet need in refractory disease.
• The increasing cases of chronic gout may be attributed to ageing populations and greater longevity; rising cardiometabolic risk factors (obesity, metabolic syndrome, diabetes); declining kidney function and increased diuretic use; higher intake of purine- and fructose-rich foods and alcohol; and improved detection and disease awareness.
• Most chronic gout treatments—such as allopurinol, febuxostat, and probenecid—are available as generics, offering broad, cost-effective options for long-term urate-lowering therapy, while KRYSTEXXA (pegloticase) remains a branded, US FDA-approved biologic specifically indicated for adults with chronic gout refractory to conventional therapy. 
• An unmet need persists for patients with refractory disease, intolerance to standard agents, or persistent tophaceous gout, where sustained urate reduction and prevention of flares remain challenging despite optimal available treatments.
• Emerging therapies such as NASP, pozdeutinurad, and lingdolinurad, among others, aim to address these gaps by offering novel mechanisms, improved tolerability, and potential for more durable urate control in patients unresponsive to existing options.
• In July 2025, Arthrosi Therapeutics announced that over 50% of patients had been enrolled in its pivotal Phase III REDUCE 1 trial of pozdeutinurad for gout, including tophaceous gout. The trial, progressing ahead of schedule with full enrollment expected in the second half of 2025, is being conducted in parallel with REDUCE 2 to evaluate the drug’s efficacy in lowering serum urate levels and resolving target tophi.

DelveInsight’s comprehensive report titled “Chronic Gout — Market Insights, Epidemiology, and Market Forecast – 2034” offers a detailed analysis of chronic gout. The report presents historical and projected epidemiological data covering total diagnosed prevalent cases of gout, type-specific diagnosed prevalent cases of gout, total diagnosed prevalent cases of chronic gout, and treated cases of chronic gout. In addition to epidemiology, the market report encompasses various aspects related to the patient population. These aspects include the diagnosis process, prescription patterns, physician perspectives, market accessibility, treatment options, and prospective developments in the market across seven major markets: the United States, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan, spanning from 2020 to 2034.

The report analyzes the existing treatment practices and unmet medical requirements in chronic gout. It evaluates the market potential and identifies potential business prospects for enhancing therapies or interventions. This valuable information enables stakeholders to make well-informed decisions regarding product development and strategic planning for the market.

Chronic Gout Overview

Chronic gout, also known as chronic tophaceous gout, represents the most advanced stage of the disease and typically arises when uric acid levels remain inadequately controlled over time. This stage is marked by the presence of tophi—visible or palpable deposits of urate crystals—that can develop in joints, cartilage, bones, bursae, and under the skin. These tophi may cause joint deformities, limited mobility, and disfigurement, particularly when located in small joints such as the fingers. In some cases, tophi can become painful, infected, or lead to serious complications such as joint destruction and kidney stones. Although modern urate-lowering therapies have significantly reduced the incidence of chronic gout, patients who do progress to this stage often require long-term treatment to manage symptoms, prevent further damage, and potentially resolve existing tophi.

Chronic Gout Diagnosis and Treatment Algorithm 

Chronic gout is diagnosed primarily through clinical assessment, focusing on a history of sudden, severe joint pain—often in the first metatarsophalangeal joint—accompanied by redness and swelling. Definitive diagnosis is achieved by identifying monosodium urate crystals in synovial fluid under polarized light microscopy, though this is not always feasible. Elevated serum uric acid supports the diagnosis but does not always align with symptoms. Imaging such as X-ray, ultrasound, or dual-energy CT can detect urate deposits and exclude other causes when uncertainty remains. Joint aspiration remains the gold standard, particularly in atypical cases or when infection must be ruled out.

Management aims to control acute flares and maintain serum uric acid below 6 mg/dL to prevent recurrence and joint damage. Acute attacks are treated promptly with NSAIDs, colchicine, or corticosteroids. For long-term control, urate-lowering therapy—typically allopurinol, including in moderate to severe chronic kidney disease—is initiated at a low dose and titrated to target; febuxostat is an alternative for intolerance. Anti-inflammatory prophylaxis with colchicine or NSAIDs for 3–6 months reduces flare risk when starting therapy. Ongoing patient education, lifestyle changes, and regular monitoring are essential for sustained disease control and improved quality of life.

Chronic Gout Epidemiology

The epidemiology section of the chronic gout market report offers information on the patient populations, including historical and projected trends for each of the seven major markets. Examining key opinion leader views from physicians or clinical experts can assist in identifying the reasons behind historical and projected trends. The diagnosed patient pool, their trends, and the underlying assumptions are all included in this section of the report.

This section also presents the data with relevant tables and graphs, offering a clear and concise view of the prevalence of chronic gout. Additionally, the report discloses the assumptions made during the analysis, ensuring data interpretation and presentation transparency. This epidemiological data is valuable for understanding the disease burden and its impact on the patient population across various regions.

Key Findings

According to secondary research, the prevalence of gout among US adults is 3.9%, with a higher burden in men at 5.2% and in women at 2.7%. 

As per the secondary analysis, approximately 13% of patients with gout had chronic gout marked by uncontrolled serum urate levels and persistent clinical manifestations.

In Germany, the prevalence of gout among adults is estimated to be between 1–2%.

As per available data, the prevalence of gout in the adult population of France was around 0.9 percent.

According to the secondary research, the prevalence of gout in the UK was around 2.49 percent.

In Japan, the prevalence of gout was 1.1%, with a significantly higher rate in men at 1.9% and less than 0.1% in women.

The epidemiology of chronic gout is expected to change during the forecast period (2025-2034).

Chronic Gout Market Outlook

The chronic gout therapeutics market is further expected to increase by the major drivers, such as the rising prevalent population, technological advancements, and upcoming therapies in the forecast period (2025–2034).

With ongoing research and continued dedication, the future holds hope for even more effective treatments and, ultimately, a cure for this challenging condition. According to DelveInsight, the chronic gout market in the 7MM is expected to change significantly during the forecast period 2025–2034.

Chronic Gout Drug Chapters 

Marketed Chronic Gout Drugs

KRYSTEXXA (pegloticase): Amgen

KRYSTEXXA (pegloticase) is a PEGylated uric acid–specific enzyme administered via intravenous injection. It is indicated for the treatment of chronic gout in adult patients who are refractory to conventional therapies. By enzymatically converting uric acid to allantoin, a more soluble and easily excreted compound, KRYSTEXXA lowers serum urate levels in patients with uncontrolled gout who have not responded adequately to standard treatment options.

In October 2023, Amgen completed its acquisition of Horizon Therapeutics in a transaction valued at approximately USD 27.8 billion, strengthening its portfolio in rare diseases.

In July 2022, the US FDA expanded KRYSTEXXA’s labeling to include co-administration with methotrexate for patients with uncontrolled gout.

In September 2010, the US FDA approved KRYSTEXXA for the treatment of gout.

Note: Detailed marketed therapies assessment will be provided in the final report

Emerging Chronic Gout Drugs

The chronic gout market is expected to evolve gradually, driven by the limited number of emerging therapies currently in development. Key players such as NASP, pozdeutinurad, lingdolinurad among others are showing active commitment to addressing this unmet need, with ongoing efforts to advance novel treatment options for this complex condition.

NASP (formerly SEL-212): Swedish Orphan Biovitrum (Sobi)/Cartesian Therapeutics

NASP (nanoencapsulated sirolimus plus pegadricase) is a novel, once-monthly investigational combination therapy for chronic refractory gout, designed to lower serum urate levels and help reduce tissue urate deposits that can lead to gout flares and joint deformities if untreated.

In July 2024, Sobi began a rolling Biologics License Application (BLA) submission to the US FDA for NASP (formerly SEL-212), backed by pivotal DISSOLVE I and II data, with a regulatory decision anticipated in 2026.

The milestone follows the US FDA granting Fast Track designation to NASP in March 2024, highlighting the need for new therapies for chronic refractory gout.

Since July 2020, Sobi has held rights to develop, register, and commercialize NASP outside China under a licensing deal with Cartesian Therapeutics, with up to approximately USD 585 million in milestone payments and double-digit royalties due to Cartesian based on future net sales.

Pozdeutinurad (AR882): Arthrosi Therapeutics

Pozdeutinurad (AR882) is a highly potent and selective next-generation urate transporter 1 (URAT1) inhibitor in development for the treatment of gout, targeting serum urate reduction, flare prevention, and tophi resolution. It is currently in Phase III for the chronic management of gout and in Phase II for refractory tophaceous gout. In Phase II studies, AR882 showed superior efficacy over standard-of-care therapies, with the 75 mg dose reducing serum urate to <4 mg/dL in 88% of patients—compared to none with allopurinol or febuxostat. It also demonstrated complete tophi resolution in a Phase IIb trial and a favorable safety profile.

In June 2025, Arthrosi Therapeutics presented two studies at the European Alliance of Associations for Rheumatology (EULAR) Congress in Barcelona, highlighting the potential of its next-generation URAT1 inhibitor for reducing serum urate levels, flares, and dissolving tophi in patients with gout and tophaceous gout.

In March 2025, Arthrosi Therapeutics announced two key milestones in its Phase III program for pozdeutinurad (AR882). The company completed enrollment ahead of schedule in the pivotal global REDUCE 2 trial for the treatment of gout and tophaceous gout and also dosed the first patient in the replicate REDUCE 1 trial. Both studies are running in parallel to evaluate the efficacy of pozdeutinurad in lowering serum urate levels and resolving tophi.

In December 2024, Arthrosi Therapeutics announced that over 50% of patients had been enrolled in its pivotal Phase III REDUCE 2 trial evaluating pozdeutinurad for lowering serum urate levels in patients with gout, including those with tophaceous gout.

In August 2024, Arthrosi Therapeutics received US FDA Fast Track Designation for pozdeutinurad for the potential treatment of clinically visible tophi in patients with gout.

Lingdolinurad (ABP-671): Atom Therapeutics

ABP-671 is a once-daily oral inhibitor of urate transporter 1 (URAT1) that reduces uric acid reabsorption in the kidneys, promoting urinary excretion and lowering serum uric acid (sUA) levels. Long-term use helps dissolve existing tophi, prevent gout flares, and reduce hyperuricemia-related complications such as cardiovascular, renal, and metabolic disorders. Clinical guidelines recommend maintaining sUA below 6 mg/dL to prevent new crystal formation and below 5 mg/dL to accelerate tophi resolution. In a Phase IIa trial, ABP-671 achieved these targets in 93% (<6 mg/dL) and 77% (<5 mg/dL) of patients, supporting its advancement to global Phase III trials and commercialization by Atom Therapeutics.

In May 2025, Atom Therapeutics joined the Gout Education Society’s Gout Awareness Day to raise public awareness about the risk factors and treatment options for gout. The company’s lead candidate, lingdolinurad (ABP-671), is in Phase IIb/III trials for chronic gout and hyperuricemia.

In November 2024, Atom Therapeutics presented positive Phase I data at the American College of Rheumatology (ACR) Convergence, showing that its novel oral URAT1 inhibitor ABP-671 was safe, well tolerated, and reduced serum uric acid levels in all participants with mild to moderate chronic kidney disease. The therapy is currently in global Phase IIb/III trials for chronic gout.

Note: Detailed emerging therapies assessment will be provided in the final report.

Chronic Gout Market Segmentation

DelveInsight’s ‘Chronic Gout – Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a detailed outlook of the current and future chronic gout market, segmented within countries, by therapies, and by classes. Further, the market of each region is then segmented by each therapy to provide a detailed view of the current and future market share of all therapies. 

Chronic Gout Market Size by Countries

The chronic gout market size is assessed separately for various countries, including the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan. In 2024, the United States held a significant share of the overall 7MM (Seven Major Markets) chronic gout market, primarily attributed to the country’s higher prevalence of the condition and the elevated cost of the available treatments. This dominance is projected to persist, especially with the potential early introduction of new products.

Chronic Gout Market Size by Therapies

Chronic Gout Market Size by Therapies is categorized into current and emerging markets for the study period 2020–2034. 

Note: Detailed market segment assessment will be provided in the final report.

Chronic Gout Drugs Uptake

This section focuses on the sales uptake of potential chronic gout drugs that have recently been launched or are anticipated to be launched in the chronic gout market between 2020 and 2034. It estimates the market penetration of chronic gout drugs for a given country, examining their impact within and across classes and segments. It also touches upon the financial and regulatory decisions contributing to the probability of success (PoS) of the drugs in the chronic gout market.

The emerging chronic gout therapies are analyzed based on various attributes such as safety and efficacy in randomized clinical trials, order of entry and other market dynamics, and the unmet need they fulfill in the chronic gout market.

Note: Detailed assessment of drug uptake and attribute analysis will be provided in the full report on chronic gout.

Chronic Gout Market Access and Reimbursement

DelveInsight’s ‘Chronic Gout – Market Insights, Epidemiology, and Market Forecast – 2034’ report provides a descriptive overview of the market access and reimbursement scenario of chronic gout.

This section includes a detailed analysis of the country-wise healthcare system for each therapy, enlightening the market access, reimbursement policies, and health technology assessments. 

KOL Views

To keep up with current chronic gout market trends and fill gaps in secondary findings, we interview KOLs and SMEs’ working in the chronic gout domain. Their opinion helps understand and validate current and emerging therapies and treatment patterns or chronic gout market trends. This will support the clients in potential upcoming novel treatments by identifying the overall scenario of the market and the chronic gout unmet needs.

Chronic Gout: KOL Insights

DelveInsight’s analysts connected with 25+ KOLs to gather insights; however, interviews were conducted with 10+ KOLs in the 7MM. These KOLs were from organizations, institutes, and hospitals, such as Mercer University, US, University Hospital Tübingen, Germany, University of Barcelona, Barcelona, Spain, ellvitge-Idibell University Hospital, Barcelona, Spain, University of Leeds, Leeds, UK, and University of Occupational and Environmental Health, Japan, among others.

“Chronic gout is a metabolic disorder driven by sustained hyperuricemia, leading to monosodium urate crystal deposition in joints and soft tissues. This crystal-induced inflammation causes acute flares, persistent synovial and bony changes, tophi formation, erosive joint damage, and chronic pain if untreated. Its development and severity are influenced by genetic predisposition, diet, kidney function, and comorbidities such as hypertension and obesity, underscoring the interplay of metabolic and inflammatory factors.”

“Diagnosis of chronic gout is primarily based on clinical judgment, supported by microscopic and laboratory findings. Key indicators include rapid-onset, intensely painful monoarticular arthritis (often at the first metatarsophalangeal joint), recurrent attacks, redness, and swelling. Detection of needle-shaped monosodium urate crystals in synovial fluid under polarized light microscopy is definitive but not always feasible, so diagnosis often relies on elevated serum uric acid, clinical features, radiographic evidence, and exclusion of infection. In uncertain cases, joint aspiration and imaging help confirm the diagnosis.”

“In chronic gout, acute flares are managed with NSAIDs, colchicine, or corticosteroids to quickly reduce pain and inflammation. Long-term management focuses on maintaining serum urate below 6 mg/dL, or below 5 mg/dL in severe cases, typically with xanthine oxidase inhibitors, while uricosurics or uricase therapies are used for refractory or intolerant patients. Ongoing patient education, routine monitoring, and lifestyle adjustments help maintain control and prevent disease progression.”

Note: Detailed assessment of KOL Views will be provided in the full report on Chronic Gout.

Competitive Intelligence Analysis

We conduct a Competitive and Market Intelligence analysis of the chronic gout Market, utilizing various Competitive Intelligence tools such as SWOT analysis and Market entry strategies. The inclusion of these analyses is contingent upon data availability, ensuring a comprehensive and well-informed assessment of the market landscape and competitive dynamics.

Chronic Gout Pipeline Development Activities

The report offers an analysis of therapeutic candidates in Phase III and II stages and examines companies involved in developing targeted therapeutics for chronic gout. It provides valuable insights into the advancements and progress of potential treatments in clinical development for this condition.

Pipeline Development Activities

The report covers information on collaborations, acquisition and merger, licensing, patent details, and other information for emerging chronic gout therapies.

Chronic Gout Report Insights

• Chronic Gout Patient Population
• Therapeutic Approaches
• Chronic Gout Pipeline Analysis
• Chronic Gout Market Size and Trends
• Chronic Gout Market Opportunities
• Impact of Upcoming Therapies

Chronic Gout Report Key Strengths

• 10 Years Forecast
• The 7MM Coverage
• Chronic Gout Epidemiology Segmentation
• Key Cross Competition
• Highly Analyzed Chronic Gout Market
• Chronic Gout Drugs Uptake

Chronic Gout Report Assessment

• Chronic Gout Current Treatment Practices
• Unmet Needs
• Chronic Gout Pipeline Product Profiles
• Chronic Gout Market Attractiveness

Key Questions

• How common is chronic gout?
• What are the key findings of chronic gout epidemiology across the 7MM, and which country will have the highest number of patients during the study period (2020–2034)?
• What are the currently available treatments for chronic gout?
• What are the disease risk, burden, and unmet needs of chronic gout?
• At what CAGR is the chronic gout market and its epidemiology is expected to grow in the 7MM during the forecast period (2025–2034)?
• How would the unmet needs impact the chronic gout market dynamics and subsequently influence the analysis of the related trends?
• What would be the forecasted patient pool of chronic gout in the 7MM covering the United States, EU4 (Germany, France, Italy, and Spain), the UK, and Japan?
• Among EU4 and the UK, which country will have the highest number of patients during the forecast period (2025–2034)?
• How many companies are currently developing therapies for the treatment of chronic gout?

Reasons to buy

• The report will help in developing business strategies by understanding the latest trends and changing treatment dynamics driving the chronic gout Market.
• Insights on patient burden/disease prevalence, evolution in diagnosis, and factors contributing to the change in the epidemiology of the disease during the forecast years.
• To understand the existing market opportunity in varying geographies and the growth potential over the coming years.
• Distribution of historical and current patient share based on real-world prescription data along with reported sales of current treatment in the US, EU4 (Germany, France, Italy, and Spain), the United Kingdom, and Japan.
• Identification of strong upcoming players in the market will help in devising strategies that will help in getting ahead of competitors.
• Detailed analysis and ranking of class-wise potential current and emerging therapies under the attribute analysis section to provide visibility around leading classes.
• Highlights of Access and Reimbursement policies of approved therapies, barriers to accessibility of off-label expensive therapies, and patient assistance programs.
• To understand the perspective of Key Opinion Leaders around the accessibility, acceptability, and compliance-related challenges of existing treatment to overcome barriers in the future.
• Detailed insights on the unmet needs of the existing market so that the upcoming players can strengthen their development and launch strategy.