%0 Journal Article %A William Taylor %A Nicola Dalbeth %A Kenneth G. Saag %A Jasvinder A. Singh %A Elizabeth J. Rahn %A Amy S. Mudano %A Yi-Hsing Chen %A Ching-Tsai Lin %A Paul Tan %A Worawit Louthreno %A Janitzia Vazquez-Mellado %A Hansel Hernández-Llinas %A Tuhina Neogi %A Ana B. Vargas-Santos %A Geraldo Castelar-Pinheiro %A Rodrigo B. Chaves-Amorim %A Tillman Uhlig %A Hilde B. Hammer %A Maxim Eliseev %A Fernando Perez-Ruiz %A Lorenzo Cavagna %A Geraldine M. McCarthy %A Lisa K. Stamp %A Martijin Gerritsen %A Viktoria Fana %A Francisca Sivera %A Angelo L. Gaffo %T Flare Rate Thresholds for Patient Assessment of Disease Activity States in Gout %D 2020 %R 10.3899/jrheum.191242 %J The Journal of Rheumatology %P jrheum.191242 %X 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. %U https://www.jrheum.org/content/jrheum/early/2020/11/10/jrheum.191242.full.pdf