期刊
CLINICAL AND EXPERIMENTAL RHEUMATOLOGY
卷 41, 期 3, 页码 628-633出版社
CLINICAL & EXPER RHEUMATOLOGY
DOI: 10.55563/clinexprheumatol/eh0jcp
关键词
gout; disease activity; tophi; hypouricaemia treatment; gout outcome; gout predictors
类别
Objective gout treatment is suboptimal, and the presence of tophi may predict high disease activity at 12 months, worsening patients' pain perception.
Objective Gout treatment is largely suboptimal in clinical practice. We aimed to assess the predictors of disease-activity at 12 months in a real-life setting. Methods Consecutive patients referred to Rheumatology Units for suspected acute crystal-induced arthritis were enrolled in a multicentre-cohort study. Only patients with clinical diagnosis of gout were eligible. Disease-activity was evaluated by the Patient Acceptable Symptom State (PASS) on a visual analogue scale (VAS, 0=unsatisfactory, 100=satisfactory) at 0 (T0) and 12 months (T12), and the composite score called Gout Activity Score (GAS) calculated on the number of arthritic attacks (flare count), serum uric acid (sUA), cumulative number of tophi, VAS (T12), PtGA (T12). Multivariate linear regression model was performed to assess predictors of gout disease-activity at T12 with PASS and GAS as outcomes. Results 201 patients had gout (diagnosis on synovial fluid in 45%, tophi in 26%, mean sUA 7.4 +/- 1.9 mg/L, 85% with urate-lowering therapy (ULT) in progress/initiated at T0); mean age 63 +/- 13 years, 88% men, median (interquartile range) disease duration 2.9 years (0.7-9.4). Follow-up visits were performed in 113 (56%) patients at T12. Mean PASS observed at T0 and at T12 were 38 +/- 27 and 74 +/- 23, respectively, whereas GAS at T12 was 10 +/- 8. A significant association was observed between the presence of tophi and PASS at T12 (-15.3, 95% CI -25.5, -5.2; p=0.003) and GAS at T12 (+4.0, 95% CI 0.6,7.4; p=0.02), adjusted for age, sex, disease duration, sUA <6 mg/dL, tender joint count, PASS at T0, ULT). Conclusion The baseline presence of tophi may predict high disease-activity at T12, thus worsening GAS and patients' pain perception.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据