RT Journal Article
SR Electronic
T1 Flare Rate Thresholds for Patient Assessment of Disease Activity States in Gout
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 293
OP 298
DO 10.3899/jrheum.191242
VO 48
IS 2
A1 Taylor, William
A1 Dalbeth, Nicola
A1 Saag, Kenneth G.
A1 Singh, Jasvinder A.
A1 Rahn, Elizabeth J.
A1 Mudano, Amy S.
A1 Chen, Yi-Hsing
A1 Lin, Ching-Tsai
A1 Tan, Paul
A1 Louthreno, Worawit
A1 Vazquez-Mellado, Janitzia
A1 Hernández-Llinas, Hansel
A1 Neogi, Tuhina
A1 Vargas-Santos, Ana B.
A1 Castelar-Pinheiro, Geraldo
A1 Chaves-Amorim, Rodrigo B.
A1 Uhlig, Tillman
A1 Hammer, Hilde B.
A1 Eliseev, Maxim
A1 Perez-Ruiz, Fernando
A1 Cavagna, Lorenzo
A1 McCarthy, Geraldine M.
A1 Stamp, Lisa K.
A1 Gerritsen, Martijin
A1 Fana, Viktoria
A1 Sivera, Francisca
A1 Gaffo, Angelo L.
YR 2021
UL http://www.jrheum.org/content/48/2/293.abstract
AB 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.