Shrimp and sausage haloes circle above actors’ heads in Ironwood Pharmaceutical’s first campaign for gout treatment Duzallo. The unusual crowns serve as visual reminders that while many patients may not always be perfect food choice angels, they may need more than just dietary vigilance to combat flare-ups.

Duzallo launched in October as the first combination drug to treat hyperuricemia associated with gout. The new "I’m No Angel" campaign is Ironwood’s first ad push, fueled in part by insights from last year's CreakyJoints research that Ironwood funded.

"The cultural stigma of gout … runs so deep with these patients," said Sharon DeBacco, VP of product promotion and communication at Ironwood. Gout patients are often misperceived as being overindulgent, lacking self-control, living an unhealthy lifestyle and having poor judgment, she said. One patient told them that when he's revealed to people that he has gout, "the first thing people do is look down at his stomach."

Compounding the problem is that physicians often reinforce diet as the cause of gout, fueling patient guilt. Patients overwhelmingly said doctors had told them in the past that their gout was the result of their diet and directed them to self-manage, DeBacco said.

"In effect, they shut down future opportunities for patients to come in and talk to their doctors. Which is why we found 50% of patients don’t tell their doctors when they have flare ups," she said. "Once physicians hear that a patient is flaring, they immediately understand that the patient may be uncontrolled and that their therapy should be reconsidered. But in the don’t-ask-don’t-tell world we’re living in, doctors aren’t asking and patients aren’t offering, and nothing is happening."

The campaign is already resonating with patients who in early viewing have said the ads are empathetic and authentic and show that Ironwood "understands them." In the TV ad, the narrator says, "Living with gout, temptation is everywhere. And like anyone, you’re no angel." Meanwhile, various scenes feature several middle-aged men at a barbeque, family dinner and playing pool with friends and turning down potentially troublesome foods or alcohol. It ends with the advice to "keep at it" with diet, but to also ask a doctor about Duzallo.

The effort will air on national TV—including highly visual placements in primetime spots such as "The Voice," "60 Minutes" and "NCIS," as well as major sporting events including the NHL Stanley Cup, NBA finals, Kentucky Derby and Indy 500—and also run in newspapers, magazines, targeted digital and point of care.

Meanwhile, Ironwood, which is under activist pressure, recently said it would spin off its R&D to become two separate companies. In a news release, the drugmaker said it anticipates that the new company without R&D will be profitable "building on its commercial success to-date to accelerate growth of its in-market products and advance development programs targeting treatments for gastrointestinal diseases, uncontrolled gout, and abdominal pain."

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