University of Michigan, MI, USA.
Health Qual Life Outcomes. 2012 Sep 22;10:117. doi: 10.1186/1477-7525-10-117.
The prevalence of gout is increasing, and most research on the associated burden has focused on serum urate (sUA) levels. The present study quantifies the impact of the presence of tophi and frequency of acute gout attacks on health-related quality of life (HRQOL), productivity, and healthcare resource utilization.
Patients with self-reported gout (n=620; 338 in US and 282 across France, Germany, and UK) were contacted based on inclusion in the 2010 US and EU National Health and Wellness Surveys (Kantar Health) and the Lightspeed Research ailment panel. Respondents were categorized into mutually-exclusive groups based on number of gout flares experienced in the past 12 months (0/don't recall, 1-2, 3, 4-5, 6+), current presence of tophi (none, 1+, or not sure), and sUA level awareness (yes, no). HRQOL (SF-12v2), healthcare provider visits in the last 6 months, and work productivity and activity impairment (WPAI) were compared across groups.
Most patients were males, mean age of 61 years, who reported experiencing at least one acute gout flare in the past 12 months, and 12.3% (n=76) reported presence of tophi. Among the 27.7% (n=172) of patients who were aware of their sUA levels, higher sUA was associated with more flares and tophi. Decreased HRQOL was associated with more frequent flares and presence of tophi. In multivariable models predicting outcomes based on presence of tophi and number of flares, both flares (≥4) and tophi (≥1) were associated with HRQOL decrements on physical and mental component summary scores and health utilities (all p<0.05), after adjustment for age, gender, and time since diagnosis. Flares were also associated with greater activity impairment.
Impairments associated with gout flares and presence of tophi, across patients in the US and EU, underscore the importance of effective management of this potentially curable condition.
痛风的患病率正在上升，大多数与痛风相关负担的研究都集中在血清尿酸（sUA）水平上。本研究量化了痛风石的存在和急性痛风发作的频率对健康相关生活质量（HRQOL）、生产力和医疗资源利用的影响。
根据 2010 年美国和欧盟国家健康和健康调查（Kantar Health）以及 Lightspeed Research 疾病小组的纳入情况，联系了自我报告有痛风的患者（n=620；美国 338 例，法国、德国和英国 282 例）。根据过去 12 个月内经历的痛风发作次数（无/不记得、1-2 次、3 次、4-5 次、6 次以上）、当前是否存在痛风石（无、1+或不确定）以及 sUA 水平知晓情况（是、否），将患者分为互斥组。比较各组之间的健康相关生活质量（SF-12v2）、过去 6 个月内的医疗保健提供者就诊次数以及工作生产力和活动障碍（WPAI）。
大多数患者为男性，平均年龄为 61 岁，他们报告在过去 12 个月内至少经历过一次急性痛风发作，12.3%（n=76）报告存在痛风石。在 27.7%（n=172）知晓自己 sUA 水平的患者中，较高的 sUA 与更多的发作和痛风石有关。更频繁的发作和痛风石与 HRQOL 下降有关。在基于痛风石存在和发作次数预测结局的多变量模型中，发作（≥4 次）和痛风石（≥1 个）与身体和精神成分综合评分以及健康效用的 HRQOL 下降有关（所有 p<0.05），调整年龄、性别和诊断后时间后。发作也与更大的活动障碍有关。
在美国和欧盟的患者中，痛风发作和痛风石的存在所带来的损害突出了有效管理这种潜在可治愈疾病的重要性。
