Department of Medicine, University of Otago, Christchurch, New Zealand.
Semin Arthritis Rheum. 2011 Jun;40(6):483-500. doi: 10.1016/j.semarthrit.2010.09.003. Epub 2010 Nov 5.
To determine whether serum urate (SU) fulfills the Outcome measures in Rheumatology (OMERACT) soluble biomarker criteria.
The OMERACT soluble biomarker criteria were adapted for use in chronic gout. Potential outcome measures for use in chronic gout were identified. The literature was reviewed to determine which of the potential outcome measures were appropriate and whether there was evidence within the current literature to fulfill the OMERACT biomarker criteria.
The assay for measurement of SU is reliable, internationally standardized, and readily accessible for use in clinical practice. The effects of sources of variability, including age, sex, ethnicity, circadian rhythms, body mass index, renal/hepatic function, and fasting, are well documented. Tophus regression was identified as appropriate structural outcome measure; however, given that not all patients have clinically apparent tophi, the number of gout flares is also identified as a key outcome measure.
Serum urate fulfills all the OMERACT biomarker criteria with the exception of its effects on outcome measures. Further analysis of existing and new data sets to determine whether a reduction in SU predicts a reduction in gout flares, the number/size of tophi, and patient reported outcomes using validated measures for these outcomes are required.
确定血清尿酸（SU）是否符合风湿病疗效评价（OMERACT）可溶性生物标志物标准。
对 OMERACT 可溶性生物标志物标准进行了调整，以适用于慢性痛风。确定了可用于慢性痛风的潜在结局指标。对文献进行了回顾，以确定哪些潜在的结局指标是合适的，以及当前文献中是否有证据满足 OMERACT 生物标志物标准。
SU 的检测方法具有可靠性、国际标准化和在临床实践中易于使用的特点。SU 检测方法的变异来源（包括年龄、性别、种族、昼夜节律、体重指数、肾功能和肝功能以及禁食）的影响已得到充分证实。尿酸盐结晶溶解被认为是适当的结构结局指标；然而，由于并非所有患者都有明显的痛风石，因此痛风发作次数也被确定为关键结局指标。
除了对结局指标的影响外，血清尿酸（SU）符合 OMERACT 生物标志物的所有标准。需要进一步分析现有和新数据集，以确定 SU 的降低是否可预测痛风发作次数/大小和痛风石数量的减少，以及使用这些结局的验证性措施报告患者的结局。
