RT Journal Article
SR Electronic
T1 Quality of Life and Disability in Patients with Treatment-Failure Gout
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1041
OP 1048
DO 10.3899/jrheum.071229
VO 36
IS 5
A1 MICHAEL A. BECKER
A1 H. RALPH SCHUMACHER
A1 KATY L. BENJAMIN
A1 PETER GOREVIC
A1 MARIA GREENWALD
A1 JEFFREY FESSEL
A1 LAWRENCE EDWARDS
A1 ARIANE K. KAWATA
A1 LORI FRANK
A1 ROYCE WALTRIP
A1 ALLAN MAROLI
A1 BILL HUANG
A1 The Gout Natural History Study Group
A1 JOHN S. SUNDY
YR 2009
UL http://www.jrheum.org/content/36/5/1041.abstract
AB Objective. The relationship between self-reported quality of life and disability and disease severity was evaluated in subjects with treatment-failure gout (n = 110) in a prospective, 52-week, observational study. Methods. Subjects had symptomatic crystal-proven gout of at least 2 years’ duration and intolerance or refractoriness to conventional urate-lowering therapy. Serum uric acid (sUA) concentration, swollen and tender joint counts, frequency and severity of gout flares, tophus assessments, comorbidities, and patient-reported outcomes data [Medical Outcomes Study Short Form-36 (SF-36), Health Assessment Questionnaire-Damage Index] were collected. Analyses included correlations of patient-reported outcomes with clinical variables and changes in clinical status. Results. Mean age of study subjects was 59 years. Mean scores on SF-36 physical functioning subscales were 34.2–46.8, analogous to persons aged ≥ 75 years in the general population. Subjects with more severe gout at baseline had worse health-related quality of life (HRQOL) in all areas (p < 0.02 for all measures), compared to patients with mild-moderate disease. Number of flares reported in past year, number of tender joints, swollen joints, and tophi correlated significantly with some or all HRQOL and disability measures. sUA was not significantly correlated with any HRQOL or disability measure. Subjects with comorbidities experienced worse physical, but not mental, functioning. Conclusion. Severe gout is associated with poor HRQOL and disability, especially for patients who experience more gout flares and have a greater number of involved joints. Subject perceptions of gout-related functioning and pain severity appear to be highly sensitive indicators of HRQOL and disability.