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Flare Rate Thresholds for Patient Assessment of Disease Activity States in Gout.
Taylor, William; Dalbeth, Nicola; Saag, Kenneth G; Singh, Jasvinder A; Rahn, Elizabeth J; Mudano, Amy S; Chen, Yi-Hsing; Lin, Ching-Tsai; Tan, Paul; Louthreno, Worawit; Vazquez-Mellado, Janitzia; Hernández-Llinas, Hansel; Neogi, Tuhina; Vargas-Santos, Ana B; Castelar-Pinheiro, Geraldo; Chaves-Amorim, Rodrigo B; Uhlig, Tillman; Hammer, Hilde B; Eliseev, Maxim; Perez-Ruiz, Fernando; Cavagna, Lorenzo; McCarthy, Geraldine M; Stamp, Lisa K; Gerritsen, Martijin; Fana, Viktoria; Sivera, Francisca; Gaffo, Angelo L.
Afiliación
  • Taylor W; W. Taylor, MBChB, PhD, FRACP, FAFRM, University of Otago, Wellington, New Zealand.
  • Dalbeth N; N. Dalbeth, MBChB, MD, FRACP, P. Tan, University of Auckland, Auckland, New Zealand.
  • Saag KG; K.G. Saag, MD, MSc, E.J. Rahn, PhD, A.S. Mudano, MPH, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Singh JA; J.A. Singh, MD, MPH, A.L. Gaffo, MD, MSPH, University of Alabama at Birmingham, and Birmingham VA Medical Center, Birmingham, Alabama, USA.
  • Rahn EJ; K.G. Saag, MD, MSc, E.J. Rahn, PhD, A.S. Mudano, MPH, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Mudano AS; K.G. Saag, MD, MSc, E.J. Rahn, PhD, A.S. Mudano, MPH, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • Chen YH; Y.H. Chen, MD, PhD, C.T. Lin, MD, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Lin CT; Y.H. Chen, MD, PhD, C.T. Lin, MD, Taichung Veterans General Hospital, Taichung, Taiwan.
  • Tan P; N. Dalbeth, MBChB, MD, FRACP, P. Tan, University of Auckland, Auckland, New Zealand.
  • Louthreno W; W. Louthreno, MD, Chiang Mai University, Chiang Mai, Thailand.
  • Vazquez-Mellado J; J. Vazquez-Mellado, MD, PhD, H. Hernández-Llinas, MD, Hospital General de Mexico, Mexico City, Mexico.
  • Hernández-Llinas H; J. Vazquez-Mellado, MD, PhD, H. Hernández-Llinas, MD, Hospital General de Mexico, Mexico City, Mexico.
  • Neogi T; T. Neogi, MD, PhD, FRCPC, A.B. Vargas-Santos, MD, Boston University School of Medicine, Boston, Massachusetts, USA.
  • Vargas-Santos AB; T. Neogi, MD, PhD, FRCPC, A.B. Vargas-Santos, MD, Boston University School of Medicine, Boston, Massachusetts, USA.
  • Castelar-Pinheiro G; G. Castelar-Pinheiro, MD, PhD, R.B. Chaves-Amorim, MD, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
  • Chaves-Amorim RB; G. Castelar-Pinheiro, MD, PhD, R.B. Chaves-Amorim, MD, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
  • Uhlig T; T. Uhlig, MD, H.B. Hammer, MD, PhD, Diakonhjemmet Hospital, Oslo, Norway.
  • Hammer HB; T. Uhlig, MD, H.B. Hammer, MD, PhD, Diakonhjemmet Hospital, Oslo, Norway.
  • Eliseev M; M. Eliseev, PhD, V.A. Nasonova Research Institute of Rheumatology, Moscow, Russia.
  • Perez-Ruiz F; F. Perez-Ruiz, MD, PhD, Servicio de Reumatologia, Baracaldo, Spain.
  • Cavagna L; L. Cavagna, MD, University and IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
  • McCarthy GM; G.M. McCarthy, MD, FRCPI, Mater Misericordiae University Hospital, Dublin, Ireland.
  • Stamp LK; L.K. Stamp, MBChB, FRACP, PhD, University of Otago-Christchurch, Christchurch, New Zealand.
  • Gerritsen M; M. Gerritsen, MD, PhD, Westfries Gasthuis, Hoorn, the Netherlands.
  • Fana V; V. Fana, MD, Copenhagen Center for Artritis Reserch, Righospitalet Glostrup, Denmark.
  • Sivera F; F. Sivera, MD, PhD, Hospital General Universitario Elda, Elda, Spain.
  • Gaffo AL; J.A. Singh, MD, MPH, A.L. Gaffo, MD, MSPH, University of Alabama at Birmingham, and Birmingham VA Medical Center, Birmingham, Alabama, USA; agaffo@uabmc.edu.
J Rheumatol ; 48(2): 293-298, 2021 02.
Article en En | MEDLINE | ID: mdl-32358154
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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Gota Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: J Rheumatol Año: 2021 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Canadá
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Gota Tipo de estudio: Prognostic_studies Límite: Humans Idioma: En Revista: J Rheumatol Año: 2021 Tipo del documento: Article País de afiliación: Nueva Zelanda Pais de publicación: Canadá