TY - JOUR T1 - Flare Rate Thresholds for Patient Assessment of Disease Activity States in Gout JF - The Journal of Rheumatology JO - J Rheumatol DO - 10.3899/jrheum.191242 SP - jrheum.191242 AU - William Taylor AU - Nicola Dalbeth AU - Kenneth G. Saag AU - Jasvinder A. Singh AU - Elizabeth J. Rahn AU - Amy S. Mudano AU - Yi-Hsing Chen AU - Ching-Tsai Lin AU - Paul Tan AU - Worawit Louthreno AU - Janitzia Vazquez-Mellado AU - Hansel Hernández-Llinas AU - Tuhina Neogi AU - Ana B. Vargas-Santos AU - Geraldo Castelar-Pinheiro AU - Rodrigo B. Chaves-Amorim AU - Tillman Uhlig AU - Hilde B. Hammer AU - Maxim Eliseev AU - Fernando Perez-Ruiz AU - Lorenzo Cavagna AU - Geraldine M. McCarthy AU - Lisa K. Stamp AU - Martijin Gerritsen AU - Viktoria Fana AU - Francisca Sivera AU - Angelo L. Gaffo Y1 - 2020/05/01 UR - http://www.jrheum.org/content/early/2020/11/10/jrheum.191242.abstract N2 - Objective To determine the relationship between gout flare rate and self-categorization into remission, low disease activity (LDA), and patient acceptable symptom state (PASS). Methods Patients with gout self-categorized as remission, LDA, and PASS, and reported number of flares over the preceding 6 and 12 months. Multinomial logistic regression was used to determine the association between being in each disease state (LDA and PASS were combined) and flare count, and self-reported current flare. A distribution-based approach and extended Youden index identified possible flare count thresholds for each state. Results Investigators from 17 countries recruited 512 participants. Remission was associated with a median recalled flare count of zero over both 6 and 12 months. Each recalled flare reduced the likelihood of self-perceived remission compared with being in higher disease activity than LDA/PASS, by 52% for 6 months and 23% for 12 months, and the likelihood of self-perceived LDA/PASS by 15% and 5% for 6 and 12 months, respectively. A threshold of 0 flares in preceding 6 and 12 months was associated with correct classification of self-perceived remission in 58% and 56% of cases, respectively. Conclusion Flares are significantly associated with perceptions of disease activity in gout, and no flares over the prior 6 or 12 months is necessary for most people to self-categorize as being in remission. However, recalled flare counts alone do not correctly classify all patients into self-categorized disease activity states, suggesting that other factors may also contribute to self-perceived gout disease activity. ER -